OBJECTIVES This study sought to evaluate the association and burden of coronary artery calcium (CAC) with long-term, cause-specific mortality across the spectrum of baseline risk. BACKGROUND Although CAC is a known predictor of short-term, all-cause mortality, data on long-term and cause-specific mortality are inadequate. METHODS The CAC Consortium cohort is a multicenter cohort of 66,636 participants without coronary heart disease (CHD) who underwent CAC testing. The following risk factors (RFs) were considered: 1) current cigarette smoking; 2) dyslipidemia; 3) diabetes mellitus; 4) hypertension; and 5) family history of CHD. RESULTS During the 12.5-years median follow-up, 3,158 (4.7%) deaths occurred; 32% were cardiovascular disease (CVD) deaths. Participants with CAC scores ≥400 had a significantly increased risk for CHD and CVD mortality (hazard ratio [HR]: 5.44; 95% confidence interval [CI]: 3.88 to 7.62; and HR: 4.15; 95% CI: 3.29 to 5.22, respectively) compared with CAC of 0. Participants with ≥3 RFs had a smaller increased risk for CHD and CVD mortality (HR: 2.09; 95% CI: 1.52 to 2.85; and HR: 1.84; 95% CI: 1.46 to 2.31, respectively) compared with those without RFs. Across RF strata, CAC added prognostic information. For example, participants without RFs but with CAC ≥400 had significantly higher all-cause, non-CVD, CVD, and CHD mortality rates compared with participants with ≥3 RFs and CAC of 0. CONCLUSIONS Across the spectrum of RF burden, a higher CAC score was strongly associated with long-term, all-cause mortality and a greater proportion of deaths due to CVD and CHD. Absence of CAC identified people with a low risk over 12 years of follow-up, with most deaths being non-CVD in nature, regardless of RF burden.

中文翻译：

---

冠状动脉钙与预测CVD / CHD死亡率的危险因素之间的相互作用：CAC联合会。

目的本研究旨在评估基线风险范围内冠状动脉钙（CAC）与长期，因病原因导致的死亡率之间的关联和负担。背景技术尽管CAC是短期，全因死亡率的已知预测因素，但有关长期和特定原因死亡率的数据仍然不足。方法CAC联盟队列是由66,636名没有进行过CAC测试的无冠心病（CHD）的参与者组成的多中心队列。考虑了以下风险因素（RFs）：1）当前吸烟；2）血脂异常；3）糖尿病；4）高血压；5）冠心病家族史。结果在12.5年的中位随访期间，发生了3,158（4.7％）例死亡。32％是心血管疾病（CVD）死亡。CAC得分≥400的参与者患冠心病和CVD的风险显着增加（危险比[HR]：5.44； 95％置信区间[CI]：3.88至7.62； HR：4.15； 95％CI：3.29至5.22， RF≥3的参与者的CHD和CVD死亡率增加的风险较小（HR：2.09； 95％CI：1.52至2.85； HR：1.84； 95％CI：1.46至2.31。 ）与没有RF的广告进行比较。在整个RF层中，CAC添加了预后信息。例如，与RF≥3且CAC为0的参与者相比，没有RF且CAC≥400的参与者的全因，非CVD，CVD和CHD死亡率要高得多。 CAC评分与长期全因死亡率以及由CVD和CHD导致的更大比例的死亡密切相关。