Progression of Coronary Artery Calcification According to Changes in Risk Factors in Asymptomatic Individuals

Area of Science:

• Cardiology
• Radiology
• Preventive Medicine

Background:

• Coronary artery calcium (CAC) scoring is a valuable tool for cardiovascular risk assessment.
• Understanding the progression of CAC in relation to risk factor changes is crucial for refining preventive strategies.

Purpose of the Study:

• To evaluate the progression of coronary artery calcium (CAC) in asymptomatic adults over time.
• To identify predictors of rapid CAC progression, focusing on demographic factors and traditional cardiovascular risk factors.

Main Methods:

• Retrospective analysis of serial computed tomography (CT) measurements in 448 asymptomatic adults with >1-year intervals.
• Assessment of CAC progression (ΔCAC/year > 20) based on age, sex, diabetes, hypertension, hyperlipidemia, smoking, and initial CAC score.
• Univariate and multivariate logistic regression analyses to determine independent predictors of rapid CAC progression.

Main Results:

• Coronary artery calcifications developed in 12.8% of individuals with an initial CAC score of zero.
• Over half (53.6%) of individuals with pre-existing CAC experienced rapid progression (ΔCAC/year > 20).
• Recently diagnosed hypertension (OR, 11.3) and initial CAC score (OR, 1.05) were significant independent predictors of rapid CAC progression.

Conclusions:

• Demographic factors and traditional risk factors influence CAC progression.
• Recently diagnosed hypertension and higher initial CAC scores are the most significant drivers of rapid CAC progression.
• Individuals with higher initial CAC scores may benefit from closer monitoring and risk factor management.