An Alternative Method for Quantifying Coronary Artery Calcification: The Multi-Ethnic Study of Atherosclerosis

Details

• Personal Author:
  Brown ER ; Budoff MJ ; Kaufman JD ; Kronmal RA ; Liang CJ
• Description:
  Background: Extent of atherosclerosis measured by amount of coronary artery calcium (CAC) in computed tomography (CT) has been traditionally assessed using thresholded scoring methods, such as the Agatston score (AS). These thresholded scores have value in clinical prediction, but important information might exist below the threshold, which would have important advantages for understanding genetic, environmental, and other risk factors in atherosclerosis. We developed a semi-automated threshold-free scoring method, the spatially weighted calcium score (SWCS) for CAC in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: Chest CT scans were obtained from 6814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). The SWCS and the AS were calculated for each of the scans. Cox proportional hazards models and linear regression models were used to evaluate the associations of the scores with CHD events and CHD risk factors. CHD risk factors were summarized using a linear predictor. Results: Among all participants and participants with AS > 0, the SWCS and AS both showed similar strongly significant associations with CHD events (hazard ratios, 1.23 and 1.19 per doubling of SWCS and AS; 95% CI, 1.16 to 1.30 and 1.14 to 1.26) and CHD risk factors (slopes, 0.178 and 0.164; 95% CI, 0.162 to 0.195 and 0.149 to 0.179). Even among participants with AS = 0, an increase in the SWCS was still significantly associated with established CHD risk factors (slope, 0.181; 95% CI, 0.138 to 0.224). The SWCS appeared to be predictive of CHD events even in participants with AS = 0, though those events were rare as expected. Conclusions: The SWCS provides a valid, continuous measure of CAC suitable for quantifying the extent of atherosclerosis without a threshold, which will be useful for examining novel genetic and environmental risk factors for atherosclerosis. [Description provided by NIOSH]
• Subjects:
  Air Pollution Cardiovascular Diseases Cardiovascular System Cohort Studies Epidemiology Occupational Health Particulate Matter Safety
• Keywords:
  Agatston Score Air Pollution Author Keywords: Coronary Artery Calcium Cardiovascular Disease Cohort Studies Coronary Artery Calcium Score Genetic Factors Linear Predictor Particulates Subclinical Disease
• ISSN:
  1471-2342
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 10 ; OSHA Region 9 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  14
• Volume:
  12
• NIOSHTIC Number:
  nn:20055004
• Citation:
  BMC Med Imaging 2012 Jul; 12:14
• Contact Point Address:
  Elizabeth R Brown, Department of Biostatistics, University of Washington, Seattle, WA, USA
• Email:
  elizab@uw.edu
• CAS Registry Number:
  Calcium (CAS RN 7440-70-2)
• Federal Fiscal Year:
  2012
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  BMC Medical Imaging
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d6a136c1796df97f1cf771318375c0421a4eef252f29398a09687e49b69b7fddaa224171ad5842eb59150137b67f96074edab039b201df254d9c51333683329c
• Download URL:
  https://stacks.cdc.gov/view/cdc/217408/cdc_217408_DS1.pdf
• File Type:
  [PDF - 603.56 KB ]