A Simple Approach to the Identification of Guideline-Based Coronary Artery Calcium Score Percentiles (From the Multi-Ethnic Study of Atherosclerosis).

A Simple Approach to the Identification of Guideline-Based Coronary Artery Calcium Score Percentiles (From the Multi-Ethnic Study of Atherosclerosis). - 2022

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Absolute coronary artery calcium (CAC) scores and CAC percentiles can identify different patient groups, which could be confusing in clinical practice. We aimed to create a simple "rule of thumb" for identifying the American College of Cardiology/American Heart Association endorsed 75th CAC percentile based on age, gender, and the absolute CAC score. Using the Multi-Ethnic Study of Atherosclerosis, we calculated the age and gender-specific percent likelihood that a guideline-based absolute CAC score group (1 to 100, 100 to 300, >300) will place a patient above the 75th percentile. Also, we derived gender-specific age cutoffs by which 95% of participants with any (>0), moderate (>=100), or severe (>=300) CAC score would be over the 75th percentile. We repeated the analysis using the 90th percentile threshold and also conducted sensitivity analyses stratified by race. Any CAC >0 places 95% of women younger than 60 years and over 90% of men younger than 50 years over the 75th percentile. Moderate absolute CAC scores (>100) place nearly all men <60 years and all women <70 years over the 75th percentile. Confirmatory analysis for age cutoffs was consistent with primary analysis, with cutoffs of 48 years for men and 59 years for women indicating a 95% likelihood that any CAC would place patients over the 75th percentile. In conclusion, our study provides a simple rule of thumb (men <50 years and women <60 years with any CAC, men <60 years and women <70 years with CAC >100) for identifying CAC >75th percentile that might be readily adopted in clinical practice. Copyright © 2022 Elsevier Inc. All rights reserved.


English

0002-9149

10.1016/j.amjcard.2022.06.006 [doi] S0002-9149(22)00641-5 [pii]


IN PROCESS -- NOT YET INDEXED


MedStar Union Memorial Hospital


Internal Medicine Residency


Journal Article

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