Abstract 9550: Sex and Ethnicity Specific Burden of Coronary Artery Calcium Among Middle-Aged and Older Adults: Multi-Ethnic Study of Atherosclerosis

Abstract

Introduction: Detection of coronary artery calcium (CAC) at a low score is the ideal phase of the atherosclerotic process to start primary prevention therapies. A better understanding of how the proportion of individuals with zero, low, or moderate/high CAC changes with age, sex, and race/ethnicity may aid in determining the optimal age to perform general CAC scoring before there is a severe burden of atherosclerosis. Methods: We calculated the proportion of individuals with 1) CAC ≥1 and CAC ≥100 based on population percentiles from 6,110 participants without diabetes from the Multi-Ethnic Study of Atherosclerosis (MESA) who had a CAC scan at Visit 1 (2000-02). Results: There was an approximately 12 year age difference for when 25% of men had CAC ≥1 compared to CAC ≥100 (<45-51 years old vs 58-63 years old) compared to an approximately 14 year age difference for women (54-59 years old vs 69-75 years old). Women had a 50% prevalence of CAC ≥1 by age 69 years old (71 for Black women vs 67 for White women) compared to age 57 years old for men (62 for Black men vs 53 for White men). White men had a 50% prevalence of CAC ≥100 at age 68 years old, which was between 8-15 years younger than men of other races/ethnicities while women did not have a 50% prevalence of CAC ≥100 until age 80 years or older. In order to have at least a 25 to 50% probability of CAC ≥100, testing should be considered at ages of 55-64 for White men, 65-74 for men of other races/ethnicities and White women, and 75-84 years old for women of other races/ethnicities. Conclusion: Women developed CAC ≥1 approximately 12 years later in life than men. White men developed CAC ≥100 at a much younger age than men of other races/ethnicities, while a majority of women did not develop CAC ≥100 until age ≥80 years old. These findings may provide additional information to aid in the clinician-patient decision making process on the ideal age to perform CAC scoring, especially for those individuals who wish to rule out the presence of a moderate or high CAC score.