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Association of Traditional and Nontraditional Cardiovascular Risk Factors with Coronary Artery Calcification

Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, folsom{at}epi.umn.edu

Gregory W. Evans, MA

Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC

J. Jeffery Carr, MD, MS

Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, Division of Radiologic Sciences, Wake Forest University School of Medicine, Winston-Salem, NC

Arthur E. Stillman, MD, PhD

Division of Radiology, The Cleveland Clinic Foundation, Cleveland, OH

Atherosclerosis Risk in Communities (ARIC) Study Investigators

Coronary artery calcification assessed by computed tomography is an emerging marker of coronary atherosclerosis. The authors examined the association of coronary calcium scores with traditional and nontraditional cardiovascular risk factors. In 1999-2000, they measured coronary artery calcium in 360 participants free of known coronary artery disease who had participated in 2 centers of the Atherosclerosis Risk in Communities (ARIC) Study. They related coronary calcium scores to risk factors measured in 1987-1989. Most traditional risk factors were associated with the coronary calcium score. For example, the multivariately adjusted odds ratio for an elevated score (100 versus <100) was 3.5-fold greater per 10 years of age, 3.2-fold greater in men than in women, 3.1-fold greater with diabetes (statistically nonsignificant), and 1.4- to 1.7-fold greater per standard deviation greater increments of plasma cholesterol and pack-years of cigarettes smoked. Carotid artery intima-media thickness also was positively associated with coronary calcification. In contrast, a wide variety of hemostatic and inflammatory markers and serum chemistry values were unrelated to calcium scores. These findings reaffirmed the established role of traditional risk factors in the etiology of coronary artery disease, as assessed by computed tomography, but did not identify any important nontraditional risk factors.

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