Association of Coronary Artery Calcification with Estimated Coronary Heart Disease Risk from Prediction Models in a Community-Based Sample of Japanese Men: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).

Abstract

Aim: The clinical significance of coronary artery calcification (CAC) is not fully determined in general East Asian populations where background coronary heart disease (CHD) is less common than in USA/Western countries. We cross-sectionally assessed the association between CAC and estimated CHD risk as well as each major risk factor in general Japanese men.Methods: Participants were 996 randomly selected Japanese men aged 40–79 y, free of stroke, myocardial infarction, or revascularization. We examined an independent relationship between each risk factor used in prediction models and CAC score ≥ 100 by logistic regression. We then divided the participants into quintiles of estimated CHD risk per prediction model to calculate odds ratio of having CAC score ≥ 100. Receiver operating characteristic curve and c-index were used to examine discriminative ability of prevalent CAC for each prediction model.Results: Age, smoking status, and systolic blood pressure were significantly associated with CAC score ≥ 100 in the multivariable analysis. The odds of having CAC score ≥ 100 were higher for those in higher quintiles in all prediction models (p-values for trend across quintiles < 0.0001 for all models). All prediction models showed fair and similar discriminative abilities to detect CAC score ≥ 100, with similar c-statistics (around 0.70).Conclusions: In a community-based sample of Japanese men free of CHD and stroke, CAC score ≥ 100 was significantly associated with higher estimated CHD risk by prediction models. This finding supports the potential utility of CAC as a biomarker for CHD in a general Japanese male population.