高齢者（75歳以上）におけるびまん性冠動脈石灰化フェノタイプの予測因子：アテローム性動脈硬化リスク研究（ARIC）

Coronary artery calcium (CAC) scoring is a commonly used tool for cardiovascular disease (CVD) risk assessment and is reported using the Agatston score. However, there has been increasing interest in measures of CAC beyond the Agatston score, including measures capturing the overall distribution of vessel calcification. We assessed the association between 30-year traditional risk factor exposure and the presence of a more diffuse pattern of CAC in older adults aged 75 and older.

We studied participants in the Atherosclerosis Risk in Communities (ARIC) study who underwent CAC scoring and were free of prior CVD. Time-weighted average exposure to traditional cardiovascular risk factors (over 30 years) was calculated. The CAC diffusivity index was calculated for each participant as 1 - (CAC in most affected vessel/total CAC) to capture distribution of calcification, and associations between traditional risk factors and more diffuse CAC patterns were studied.

In 2201 participants (mean age 80, 61.8% women), time-averaged exposure to systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), ever smoking, male sex, and limited education were independently associated with more diffuse CAC (p < 0.05).

Longitudinal exposure to traditional CVD risk factors including higher SBP, higher LDL-C, lower HDL-C, and smoking was associated with a more diffuse pattern of CAC in a population of adults aged 75 and older.