Understanding the Low-Risk Population with Coronary Artery Calcifications

Abstract: Background: Coronary artery calcium (CAC) assessment has been proposed as a possible method for improving identification of persons at risk for cardiovascular disease (CVD). Current cardiovascular risk prediction algorithms identify high risk people because they have the greatest potential benefit from prevention interventions. However, since high risk people comprise a small percentage of the population, the greatest absolute number of CVD occurrences happens among people at low or intermediate risk.1 The objective of this study was to assess the prevalence of CAC and advanced CAC in low-risk populations and determine the demographics and non-invasive lab characteristics of low risk adults with CAC. Methods: In a cross-sectional analysis, we studied 420 non-diabetic participants who were not on lipid lowering therapy or anti-hypertensive medications. Bivariate analyses were used to assess the presence of CAC and advanced CAC (defined as Agatston Score >= 400) in the subset of the population deemed “low risk” by the Framingham Risk Score (FRS = 400) were 24% male with a mean age of 43 years, total cholesterol 194 mg/dl, HDL 61 mg/dl, systolic BP 120 mmHg, 24hr ambulatory BP of 139, mean BMI of 27 and 9% smokers. Among these low risk patients, female sex was the only factor significantly associated with the presence of advanced CAC. Conclusions: Among a low-risk sample of patients (FRS