Vince
Super Moderator
March 24, 2016
BALTIMORE, MA — Coronary artery calcium (CAC) is independently associated with multiple age-related chronic diseases, although less so than for CVD itself, new findings from the Multi-Ethnic Study of Atherosclerosis (MESA) suggest.[1]
A CAC imaging score of over 400 was independently associated with cancer, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and hip fractures.
"This indicates that CAC indeed appears to be a marker of unhealthy aging and accumulated risk, placing individuals at risk for a variety of important diseases," senior author Dr Michael Blaha (Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD) told heartwire from Medscape in an email.
On the other hand, patients with a CAC of zero appear to be protected from CVD and other chronic diseases. The relative hazard for a non-CVD event was cut 25% in these "healthy agers" vs those with detectable CAC, according to the report, published earlier this month in the JACC: Cardiovascular Imaging.
"Despite our findings, I don't think CAC will be used clinically to predict non-CVD diseases at this time," Blaha said. "Our research mainly implies that people with high CAC are likely at risk for a variety of diseases, which is useful information for payers, accountable care organizations, policymakers, and individual physicians."
Study DetailsThe investigators looked at 6814 MESA participants followed for a median of 10.2 years. Non-CVD diagnoses were abstracted from inpatient records by ICD-9 codes.
Half of patients did not have any coronary calcium (CAC 0), 40% had scores of 1 to 400, and 10% had scores greater than 400.
Modified Cox-proportional hazard ratios (HRs) accounting for the competing risk of fatal CHD were calculated for new diagnoses of cancer and other conditions.
Analyses were adjusted for age, gender, race, socioeconomic status, health insurance status, body mass index, physical activity, diet, tobacco use, number of medications used, systolic and diastolic blood pressure, total and HDL-cholesterol, diabetes, and use of antihypertensive, aspirin, and cholesterol medications.
After full adjustment, patients with a CAC score of over 400 were 53% more likely than those with a CAC of zero to develop cancer (HR 1.53; 95% CI 1.18–1.99).
Risk was also increased for CKD (HR 1.70; 95% CI 1.21–2.39), pneumonia (HR 1.97; 95% CI 1.37–2.82), COPD (HR 2.71; 95% CI 1.60–4.57), and hip fracture (HR, 4.29; 95% CI 1.47–12.50).
A CAC over 400 was not significantly associated with dementia or deep-venous thrombosis/pulmonary embolism (DVT/PE). This may be because they had too few dementia cases and DVT/PE may have more acute-onset risk factors such as trauma and surgery, the group reported.
Lead author Dr Catherine Handy (Johns Hopkins) urged caution in overstating the findings for hip fracture because of small case numbers, but said even they were surprised by what they found for COPD and cancer.
"Cancer was very surprising, and actually the question that I get asked most about is the association between coronary calcium and cancer, and why would those two things be related at all," she told heartwire .
Underlying MechanismsCAC is unlikely to be causally associated with non-CVD outcomes, but may be a "risk integrator" that reflects measured and unmeasured risk factors which accumulate over a lifetime, Handy said. Continue Reading
https://login.medscape.com/login/ss...0vdmlld2FydGljbGUvODYwOTMzP3NyYz1yc3M=&ac=401
BALTIMORE, MA — Coronary artery calcium (CAC) is independently associated with multiple age-related chronic diseases, although less so than for CVD itself, new findings from the Multi-Ethnic Study of Atherosclerosis (MESA) suggest.[1]
A CAC imaging score of over 400 was independently associated with cancer, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and hip fractures.
"This indicates that CAC indeed appears to be a marker of unhealthy aging and accumulated risk, placing individuals at risk for a variety of important diseases," senior author Dr Michael Blaha (Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD) told heartwire from Medscape in an email.
On the other hand, patients with a CAC of zero appear to be protected from CVD and other chronic diseases. The relative hazard for a non-CVD event was cut 25% in these "healthy agers" vs those with detectable CAC, according to the report, published earlier this month in the JACC: Cardiovascular Imaging.
"Despite our findings, I don't think CAC will be used clinically to predict non-CVD diseases at this time," Blaha said. "Our research mainly implies that people with high CAC are likely at risk for a variety of diseases, which is useful information for payers, accountable care organizations, policymakers, and individual physicians."
Study DetailsThe investigators looked at 6814 MESA participants followed for a median of 10.2 years. Non-CVD diagnoses were abstracted from inpatient records by ICD-9 codes.
Half of patients did not have any coronary calcium (CAC 0), 40% had scores of 1 to 400, and 10% had scores greater than 400.
Modified Cox-proportional hazard ratios (HRs) accounting for the competing risk of fatal CHD were calculated for new diagnoses of cancer and other conditions.
Analyses were adjusted for age, gender, race, socioeconomic status, health insurance status, body mass index, physical activity, diet, tobacco use, number of medications used, systolic and diastolic blood pressure, total and HDL-cholesterol, diabetes, and use of antihypertensive, aspirin, and cholesterol medications.
After full adjustment, patients with a CAC score of over 400 were 53% more likely than those with a CAC of zero to develop cancer (HR 1.53; 95% CI 1.18–1.99).
Risk was also increased for CKD (HR 1.70; 95% CI 1.21–2.39), pneumonia (HR 1.97; 95% CI 1.37–2.82), COPD (HR 2.71; 95% CI 1.60–4.57), and hip fracture (HR, 4.29; 95% CI 1.47–12.50).
A CAC over 400 was not significantly associated with dementia or deep-venous thrombosis/pulmonary embolism (DVT/PE). This may be because they had too few dementia cases and DVT/PE may have more acute-onset risk factors such as trauma and surgery, the group reported.
Lead author Dr Catherine Handy (Johns Hopkins) urged caution in overstating the findings for hip fracture because of small case numbers, but said even they were surprised by what they found for COPD and cancer.
"Cancer was very surprising, and actually the question that I get asked most about is the association between coronary calcium and cancer, and why would those two things be related at all," she told heartwire .
Underlying MechanismsCAC is unlikely to be causally associated with non-CVD outcomes, but may be a "risk integrator" that reflects measured and unmeasured risk factors which accumulate over a lifetime, Handy said. Continue Reading
https://login.medscape.com/login/ss...0vdmlld2FydGljbGUvODYwOTMzP3NyYz1yc3M=&ac=401
