TY - JOUR
T1 - A Simple Approach to the Identification of Guideline-Based Coronary Artery Calcium Score Percentiles (From the Multi-Ethnic Study of Atherosclerosis)
AU - Osei, Albert D.
AU - Mirbolouk, Mohammadhassan
AU - Dardari, Zeina
AU - Shea, Steven
AU - Blankstein, Ron
AU - Dzaye, Omar
AU - Nasir, Khurram
AU - Blumenthal, Roger S.
AU - Blaha, Michael J.
N1 - Funding Information:
This research was supported by contracts HHSN268201500003I, N01-HC-95159 through N01-HC-95169 from the National Heart, Lung, and Blood Institute, United States and by grants UL1-TR-000040, UL1-TR-001079, UL1-TR-001420 and UL1-TR-001881 from the National Center for Advancing Translational Sciences, United States.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/9/15
Y1 - 2022/9/15
N2 - Absolute coronary artery calcium (CAC) scores and CAC percentiles can identify different patient groups, which could be confusing in clinical practice. We aimed to create a simple "rule of thumb" for identifying the American College of Cardiology/American Heart Association endorsed 75th CAC percentile based on age, gender, and the absolute CAC score. Using the Multi-Ethnic Study of Atherosclerosis, we calculated the age and gender-specific percent likelihood that a guideline-based absolute CAC score group (1 to 100, 100 to 300, >300) will place a patient above the 75th percentile. Also, we derived gender-specific age cutoffs by which 95% of participants with any (>0), moderate (≥100), or severe (≥300) CAC score would be over the 75th percentile. We repeated the analysis using the 90th percentile threshold and also conducted sensitivity analyses stratified by race. Any CAC >0 places 95% of women younger than 60 years and over 90% of men younger than 50 years over the 75th percentile. Moderate absolute CAC scores (>100) place nearly all men <60 years and all women <70 years over the 75th percentile. Confirmatory analysis for age cutoffs was consistent with primary analysis, with cutoffs of 48 years for men and 59 years for women indicating a 95% likelihood that any CAC would place patients over the 75th percentile. In conclusion, our study provides a simple rule of thumb (men <50 years and women <60 years with any CAC, men <60 years and women <70 years with CAC >100) for identifying CAC >75th percentile that might be readily adopted in clinical practice.
AB - Absolute coronary artery calcium (CAC) scores and CAC percentiles can identify different patient groups, which could be confusing in clinical practice. We aimed to create a simple "rule of thumb" for identifying the American College of Cardiology/American Heart Association endorsed 75th CAC percentile based on age, gender, and the absolute CAC score. Using the Multi-Ethnic Study of Atherosclerosis, we calculated the age and gender-specific percent likelihood that a guideline-based absolute CAC score group (1 to 100, 100 to 300, >300) will place a patient above the 75th percentile. Also, we derived gender-specific age cutoffs by which 95% of participants with any (>0), moderate (≥100), or severe (≥300) CAC score would be over the 75th percentile. We repeated the analysis using the 90th percentile threshold and also conducted sensitivity analyses stratified by race. Any CAC >0 places 95% of women younger than 60 years and over 90% of men younger than 50 years over the 75th percentile. Moderate absolute CAC scores (>100) place nearly all men <60 years and all women <70 years over the 75th percentile. Confirmatory analysis for age cutoffs was consistent with primary analysis, with cutoffs of 48 years for men and 59 years for women indicating a 95% likelihood that any CAC would place patients over the 75th percentile. In conclusion, our study provides a simple rule of thumb (men <50 years and women <60 years with any CAC, men <60 years and women <70 years with CAC >100) for identifying CAC >75th percentile that might be readily adopted in clinical practice.
KW - Atherosclerosis
KW - Calcinosis
KW - Calcium
KW - Coronary Artery Disease
KW - Coronary Vessels
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Risk Assessment
KW - Risk Factors
KW - United States
KW - Vascular Calcification
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U2 - 10.1016/j.amjcard.2022.06.006
DO - 10.1016/j.amjcard.2022.06.006
M3 - Article
C2 - 35902315
AN - SCOPUS:85134843228
SN - 0002-9149
VL - 179
SP - 18
EP - 21
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -