Early-Life Cardiovascular Risk Factor Trajectories and Coronary Artery Calcium Progression in Midlife

Area of Science:

• Cardiovascular disease research
• Longitudinal health studies
• Biomarker analysis

Background:

• Coronary artery calcification (CAC) progression is a key indicator of cardiovascular risk.
• Understanding long-term risk factor trajectories from young adulthood to midlife is crucial for predicting CAC.
• Previous studies have not fully elucidated the combined impact of BMI, LDL-C, and MetS trajectories on CAC progression over 25 years.

Purpose of the Study:

• To investigate the 25-year trajectories of body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), and metabolic syndrome (MetS) score.
• To determine the association of these trajectories and a composite risk score with coronary artery calcification (CAC) progression.
• To identify individuals at risk for CAC progression from early adulthood to midlife.

Main Methods:

• Analysis of 2652 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study.
• Utilized coronary computed tomography at years 15, 20, and 25.
• Employed latent class trajectory modeling for BMI, LDL-C, and MetS score; Cox models assessed CAC progression associations.

Main Results:

• Over a mean of 8.9 years, 26.2% of participants showed CAC progression.
• High-risk trajectories for BMI, LDL-C, and MetS score were independently linked to increased CAC progression risk.
• A composite score of 3 high-risk trajectories was associated with a 3.73-fold increased risk of CAC progression compared to a score of 0.

Conclusions:

• Adverse trajectories of BMI, LDL-C, and MetS from early adulthood are significant predictors of CAC progression into midlife.
• A composite score based on these risk factor trajectories can aid in identifying individuals susceptible to CAC progression.
• These findings highlight the importance of long-term risk factor management for cardiovascular health.