USA: A new tool that calculates coronary artery calcium (CAC) percentile scores by age, sex, and race can help clinicians to get a fuller picture of subclinical atherosclerosis in young people aged 30-45 years, claims a recent study. The study appears in the Journal of the American College of Cardiology (JACC).
The researchers showed that the probability of CAC >0 varied by age, sex, and race in a large cohort of US adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease. CAC scores can be interpreted among young adults relative to their age-sex-race matched peers by using estimated percentiles and henceforth be included in CAC score reporting.

CAC is a measure of atherosclerotic burden and is well-validated for risk stratification in middle- to older-aged adults. However, not many studies have examined CAC in younger adults, and there is no calculator for determining age-, sex-, and race-based percentiles among people aged <45 years.
Considering the above, Aamir Javaid, University of Virginia School of Medicine, Charlottesville, Virginia, USA, and colleagues aimed to determine the probability of CAC >0 and develop age-sex-race percentiles for U.S. adults aged 30-45 years.
For this purpose, the researchers harmonized 3 datasets— Walter Reed Cohort, CARDIA (Coronary Artery Risk Development in Young Adults), and the CAC Consortium to study CAC in 19,725 asymptomatic Black and White individuals aged 30-45 years without known atherosclerotic cardiovascular disease. The probability of CAC >0 and age-sex-race percentiles of CAC distributions was estimated using nonparametric techniques after weighting each cohort equally.
The researchers reported the following findings:
The prevalence of CAC >0 was 26% among White males, 16% among Black males, 10% among White females, and 7% among Black females.
CAC >0 automatically placed all females at >90th percentile.
CAC >0 placed White males at the 90th percentile at age 34 years compared with Black males at age 37 years.
An interactive webpage allows one to enter an age, sex, race, and CAC score to obtain the corresponding estimated percentile.
The researchers concluded, "in a large cohort of U.S. adults aged 30-45 years without symptomatic atherosclerotic cardiovascular disease, the probability of CAC >0 varied by age, sex, and race."
Reference:
Javaid A, Dardari ZA, Mitchell JD, Whelton SP, Dzaye O, Lima JAC, Lloyd-Jones DM, Budoff M, Nasir K, Berman DS, Rumberger J, Miedema MD, Villines TC, Blaha MJ. Distribution of Coronary Artery Calcium by Age, Sex, and Race Among Patients 30-45 Years Old. J Am Coll Cardiol. 2022 May 17;79(19):1873-1886. doi: 10.1016/j.jacc.2022.02.051. PMID: 35550683.