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Updated: Jun 8, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Serum urate is not associated with coronary artery calcification: the NHLBI Family Heart Study
Tuhina Neogi1, Robert Terkeltaub, R Curtis Ellison
1Boston University School of Medicine, 650 Albany Street, Clin Epi Unit, Suite X-200, Boston, MA 02118, USA. tneogi@bu.edu
Insights
Serum uric acid (SUA) was not associated with coronary artery calcification (CAC) in this study. This suggests SUA may not contribute to atherosclerosis via arterial calcification, warranting further investigation into urate’s divergent effects.
Area of Science:
- Cardiovascular Disease Research
- Metabolic Syndrome Studies
- Biomarker Analysis
Background:
- Serum uric acid (SUA) is implicated in vascular remodeling and atherosclerosis.
- Previous research demonstrated an association between SUA and carotid atherosclerotic plaques.
- Coronary artery calcification (CAC) is a preclinical marker for atherosclerosis, influenced by inflammation and vascular remodeling.
Purpose of the Study:
- To investigate the association between serum uric acid (SUA) and coronary artery calcification (CAC).
- To utilize the same study sample and methods as a prior study on carotid atherosclerosis.
- To determine if SUA contributes to atherosclerosis through arterial calcification.
Main Methods:
- Analysis of data from the National Heart, Lung, and Blood Institute Family Heart Study.
- Assessment of CAC using helical computed tomography (CT) in 2412 participants.
- Sex-specific and family-cluster analyses, adjusting for cardiovascular disease and hyperuricemia risk factors.
Main Results:
- No significant association was found between SUA levels and CAC in either men or women.
- Odds ratios for increasing categories of SUA did not show a consistent trend with CAC.
- Subgroup analyses also failed to reveal any association between SUA and CAC.
Conclusions:
- Replication of methods used for carotid atherosclerosis did not identify an association between SUA and CAC.
- Findings suggest SUA may not play a role in atherosclerosis via arterial calcification.
- Further research is needed to explore potential divergent pathophysiologic effects of urate on atherosclerosis and artery calcification.
Objective:
urate may have effects on vascular remodeling and atherosclerosis. We had shown an association between serum uric acid (SUA) and carotid atherosclerotic plaques. Inflammation and vascular remodeling in atherosclerosis promote coronary artery calcification (CAC), a preclinical marker for atherosclerosis. Here, we examined whether SUA is associated with CAC, using the same study sample and methods as for our previous carotid atherosclerosis study.
Methods:
the national Heart, Lung, and Blood Institute Family Heart Study is a multicenter study designed to assess risk factors for heart disease. Participants were recruited from population-based cohorts in the US states of Massachusetts, North Carolina, Minnesota, Utah, and Alabama. CAC was assessed with helical computed tomography (CT). We conducted sex-specific and family-cluster analyses, as well as additional analyses among persons without risk factors related to both cardiovascular disease and hyperuricemia, adjusting for potential confounders as we had in the previous study of carotid atherosclerosis.
Results:
for the CAC study, 2412 subjects had both SUA and helical CT results available (55% women, age 58 ± 13 yrs, body mass index 27.6 ± 5.3). We found no association of SUA with CAC in men or women [OR in men: 1.0, 1.11, 0.86, 0.90; women: 1.0, 0.83, 1.00, 0.87 for increasing categories of SUA: < 5 (referent group), 5 to < 6, 6 to < 6.8, ≥ 6.8 mg/dl, respectively], nor in subgroup analyses.
Conclusion:
replicating the methods used to demonstrate an association of SUA with carotid atherosclerosis did not reveal any association between SUA and CAC, suggesting that SUA likely does not contribute to atherosclerosis through effects on arterial calcification. The possibility that urate has divergent pathophysiologic effects on atherosclerosis and artery calcification merits further study.
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