Cardiology · 4 h ago
Elevated CAC in young adults linked to higher 30-year mortality
In a retrospective cohort study of 12,847 adults aged 30 to 45 years, CAC scores above the 90th percentile were associated with higher all-cause, cardiovascular, and coronary mortality over a median 22.6 years of follow-up. The findings suggest long-term prognostic value for elevated CAC in this age group, but do not establish that CAC-guided treatment changes outcomes.
- Cohort included 12,847 adults aged 30 to 45 years.
- CAC above the 90th percentile was associated with higher mortality.
- Median follow-up was 22.6 years.
- Study did not test CAC-guided preventive treatment.
This retrospective cohort study used data from the CAC Consortium, which includes patients referred for clinically indicated coronary artery calcium (CAC) scans at four US institutions. Researchers assessed mortality among 12,847 adults aged 30 to 45 years, followed for a median of 22.6 years. Outcomes were all-cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality, with analyses adjusted for age, sex, and traditional atherosclerotic CVD risk factors.
During follow-up, 624 participants died, including 149 deaths from CVD and 81 from CHD. Compared with participants with a CAC score of zero, those with a score above the 90th percentile had adjusted hazard ratios of 1.87 for all-cause mortality, 2.60 for CVD mortality, and 3.71 for CHD mortality. Modeled 30-year mortality risks in these groups were 12.9% versus 7.5%, 4.5% versus 1.5%, and 3.0% versus 0.6%, respectively.
The findings support elevated CAC as a marker of long-term risk in young adults, but do not show that CAC-guided preventive treatment reduces mortality. The cohort consisted of referred patients, and the modeled 30-year risks should be interpreted in that context.
In practice
In adults aged 30 to 45 years with clinically indicated CAC scans, a CAC score above the 90th percentile was associated with higher long-term all-cause, CVD, and CHD mortality than a score of zero. These results may inform risk assessment in this population, but they do not demonstrate that CAC-guided intensification of prevention improves outcomes. Applicability is limited by the referred cohort, and the 30-year risks were modeled rather than observed over 30 years for every participant.
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JAMA Cardiology: Advanced Subclinical Atherosclerosis in Young Individuals and Risk of Mortality Over 30 Years ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.