Coronary artery calcium testing in young adults

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Imaging

Background:

• Coronary artery calcium (CAC) testing is increasingly recognized for risk stratification in younger populations.
• Premature CAC, defined as any detectable CAC in adults under 45, is present in a significant portion of young adults, particularly those with traditional atherosclerotic cardiovascular disease (ASCVD) risk factors.

Approach:

• This review synthesizes recent literature on the significance and application of CAC scoring in adults younger than 45 years.
• Examines the predictive value of CAC in young adults and the evolving understanding of risk factor associations over the lifespan.

Key Points:

• Any CAC detected in adults under 45 should be considered premature and warrants attention.
• While traditional risk factors predict CAC, their influence may diminish with age, highlighting the need for early screening.
• CAC in young adults is a strong predictor of incident ASCVD mortality, distinct from non-ASCVD causes.

Conclusions:

• The identification of premature CAC is crucial, indicating that calcific atherosclerosis can be detected earlier than previously understood.
• Selective use of CAC scoring via non-contrast computed tomography in at-risk young adults can guide early interventions, including lifestyle modifications and pharmacotherapies, to prevent later-life ASCVD.