Coronary artery calcification and total mortality in elderly men

Area of Science:

• Cardiology
• Gerontology
• Public Health

Background:

• Coronary artery calcification (CAC) is a marker of atherosclerosis.
• The association between CAC and mortality in very elderly individuals with preserved cognitive function is not well-established.
• Traditional cardiovascular risk factors may have diminished predictive power in advanced age.

Purpose of the Study:

• To investigate the relationship between coronary artery calcification (CAC) and all-cause mortality.
• To assess the predictive value of CAC for mortality in a cohort of elderly men.

Main Methods:

• Prospective cohort study within the Honolulu Heart Program.
• Inclusion of 224 elderly men (aged 84-96) with good cognitive function.
• CAC determination via physical examination from 2004-2005, followed by up to 3 years for mortality.

Main Results:

• A significant, consistent increase in mortality risk was observed with rising CAC scores (P=.001).
• No deaths occurred in individuals with CAC scores below 10.
• Mortality rates increased substantially with higher CAC scores, from 13.2 to 48.6 per 1,000 person-years for scores of 10-100 and >1000, respectively.
• CAC remained the sole significant predictor of mortality after adjusting for age and traditional risk factors.

Conclusions:

• Elevated CAC scores in elderly men are significantly associated with increased mortality risk.
• CAC screening may be a valuable tool for identifying elderly individuals at higher risk of death.
• CAC assessment could inform strategies for improving longevity in older populations, particularly when traditional risk factors are less influential.