People with a high coronary artery calcium (CAC) score puts them at increased risk not only for heart and vascular disease, but also for chronic obstructive pulmonary disease (COPD), cancer, and chronic kidney disease, according to the findings of a 10-year follow-up study of more than 6,000 people who underwent heart computed tomography (CT) scans.
The study, “The Association of Coronary Artery Calcium With Noncardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis,” was recently published in the Journal of the American College of Cardiology: Cardiovascular Imaging.
CAC is considered a measure of vascular aging, associated with an increased risk of cardiovascular and all-cause mortality.
“Plaque in the arteries is the result of cumulative damage and inflammation, and vulnerability to injury and chronic inflammation likely contributes to diseases like cancer, kidney and lung diseases, as well as cardiovascular disease,” said Michael Blaha, M.D., MPH, director of clinical research for the Ciccarone Center for the Prevention of Heart Disease and assistant professor of medicine at Johns Hopkins University School of Medicine, in a news release. “So it makes sense that the coronary calcium score — a measure of arterial aging — is predictive of noncardiovascular diseases, too.
“The reason the coronary calcium score may work so well at identifying vulnerability to a variety of chronic diseases is because it’s a direct measurement of the cumulative effect of all risk factors, rather than a consideration of a single risk factor, like obesity, smoking, or high blood pressure,” Blaha said.
The research team investigated the possible association between CAC and incident noncardiovascular disease. A total of 6,814 participants from six MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10.2 years. During this period, participants underwent follow-up visits to review their diagnosis status. All participants were of either white, African-American, Chinese, or Hispanic descent, between 45 and 84 years old, and free of cardiovascular disease at the time of an initial heart CT scan and coronary calcium score calculation.
The results revealed that after 10 years, 1,238 of the participants were diagnosed with a noncardiovascular disease, including lung disease, pneumonia, a blood clot, dementia, hip fracture, kidney disease, and cancers of the lung, prostate, gastrointestinal/colon, skin, blood, breast, or uterine/ovarian.
Compared to those with a CAC score of 0, participants with CAC scores of greater than 400 had an increased risk of cancer, COPD, pneumonia, chronic kidney disease, and hip fracture. The results also showed that CAC levels greater than 400 were not associated with dementia or deep vein thrombosis/pulmonary embolism.
Participants with CAC levels equal to 0 had a decreased risk of cancer, chronic kidney disease, COPD, and hip fracture, compared to those with CAC sc0res greater than 0. CAC equal to 0 was found to be not associated with less pneumonia, dementia, or deep vein thrombosis/pulmonary embolism.
According to researchers, after adjusting for other factors, participants with CAC levels greater than 400 had a 53 percent increased risk of developing cancer during follow-up.
“Participants with elevated CAC were at increased risk of cancer, [chronic kidney disease], COPD, and hip fractures,” researchers concluded. “Those with CAC = 0 are less likely to develop common age-related comorbid conditions, and represent a unique population of ‘healthy agers.’”
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