Clinical InvestigationImaging and Diagnostic TestingCardiovascular events with absent or minimal coronary calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)
Section snippets
Recruitment and baseline examination
The MESA cohort6 is a longitudinal, population-based study of 6,814 men and women, free of clinical cardiovascular disease, aged 45 to 84 years at baseline, and recruited from 6 field centers: Baltimore, MD; Chicago, IL; Forsyth County, NC; Los Angeles, CA; New York, NY; and St. Paul, MN. Specific racial/ethnic groups enrolled included white, black, Hispanic, and Chinese. Approximately 50% of the participants enrolled were female. Details of the MESA recruitment strategy are contained elsewhere.
Study cohort
In the MESA population of 6,814 at baseline, 5 participants were discovered to have had a cardiovascular event before enrollment and as a result were excluded from the analysis. In addition, 2,890 individuals with CAC >10 were also excluded from the study population. The final study population consisted of 3,923 asymptomatic individuals free of known cardiovascular disease at baseline (mean age 58 ± 589 years, 39% males). Overall, 3415 individuals had no detectable CAC, whereas 508 had CAC
Discussion
This large, population based multiethnic study demonstrated a remarkably low rate of cardiovascular events among those individuals with calcium scores of zero. This is concordant with prior study results.5 Conventional cardiovascular risk factors, particularly smoking and diabetes mellitus, are associated with a higher relative risk of CHD with no CAC, although absolute event rates remain low. Individuals with low CAC scores (1-10) had a 3-fold increased risk of CHD compared to those with no
Acknowledgements
This research was supported by R01 HL071739 and contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute. The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.
References (19)
- et al.
Sudden death: lessons from subsets in population studies
J Am Coll Cardiol
(1985) - et al.
Coronary calcium predicts events better with absolute calcium scores than age-gender-race percentiles—The Multi-Ethnic Study of Atherosclerosis (MESA)
J Am Coll Cardiol
(2009) - et al.
Diagnostic and prognostic value of absence of coronary artery calcification
JACC Cardiovasc Imaging
(2009) - et al.
Absence of coronary artery calcification and all-cause mortality
JACC Cardiovasc Imaging
(2009) - et al.
Quantification of coronary artery calcium using ultrafast computed tomography
J Am Coll Cardiol
(1990) - et al.
Quantitation of coronary arterial narrowing at necropsy in sudden coronary death: analysis of 31 patients and comparison with 25 control subjects
Am J Cardiol
(1979) - et al.
From vulnerable plaque to vulnerable patient—part iii: executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force Report
Am J Cardiol
(2006) - et al.
Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients
J Am Coll Cardiol
(2007) - et al.
Emerging epidemic of cardiovascular disease in developing countries
Circulation
(1998)