Assessment of Coronary Artery Calcification in Elderly Adults

Background: Early identification of atherosclerosis in older adults is paramount due to high cardiovascular morbidity and mortality. Our aim was to investigate CAC in a population of adults 55 years without previous history of cardiovascular heart disease (CHD) and its association with cardiovascular risk factors. Methods: This was a retrospective analysis of 6,573 individuals with a mean age of 61.8 years (range 55-85; 68.2% males) who underwent Electron Beam Computed Tomography for CAC score (CACS) assessment. Results: CAC was present in 70.5% of the overall cohort (78.8% of males and 52.7% of females). Twenty six per cent (26%) of those with CAC did not have any CHD risk factors. CACS ranged from 0 to 7,908 (mean 223.3±512.9); males presented a higher mean CACS (284.57 ± 571.1), compared to females (mean CACS 92.2 ± 324.8), p<0.0001. The mean CACS in males increased from 154.2 for ages 55-59 years to 760.2 in those aged 80 to 84 whilst in females mean CACS increased from 39.5 to 224.4, for corresponding age groups. The mean CACS appears to increase with age irrespective of gender. In each gender, age and hypercholesterolemia were associated with higher CACS. Furthermore, in males family history and DM were positively associated with CACS while in females, smoking status and hypertension were positively associated with CACS. Conclusion: A broad distribution of CACS was seen in older subjects. Assessment of CACS may place patients into a higher risk group for future events, and lead to more aggressive treatment with preventative therapies.