Researchers here find that even quite low levels of calcification of arteries at younger ages associates with a raised risk of heart disease going forward. Calcification is a process that has is yet to be firmly placed in the chain of cause and consequence for age-related damage in blood vessel tissues. The evidence leans towards it being a consequence of primary damage such as waste accumulating in cell lysosomes, forms of persistent cross-linking that stiffen blood vessels and senescent cell accumulation that produces inflammation, insofar as growing calcification appears to be a cellular process, the result of changed and inappropriate cellular behavior. So in this sense, calcification is a marker of the progression of damage in aging, and more of it should absolutely be expected to correlate with the risk of age-related disease.
Researchers have found that the mere presence of even a small amount of calcified coronary plaque, more commonly referred to as coronary artery calcium (CAC), in people under age 50 was strongly associated with increased risk of developing clinical coronary heart disease over the ensuing decade. The study also revealed that those with the highest coronary artery calcium scores, as measured by computed tomography (CT) scan, had a greater than 20 percent chance of dying of a heart event over that same time period. CAC has long been associated with coronary heart disease and cardiovascular disease. However, prognostic data on CAC in younger adults - people in their 30s and 40s - have been very limited.
"We always thought you had to have a certain amount of this plaque before you were at risk of having events. What our findings demonstrate is that, for women and women less than 50 years of age, any amount of coronary artery calcium significantly increased risk of clinical heart disease. Any measurable CAC in early middle age - scores of less than 100, and even less than 20 - has a 10 percent risk of acute myocardial infarction, both fatal and non-fatal, over the next decade beyond standard risk factors." The study points to CAC as a very specific imaging biomarker for identifying those people who are at risk earlier in life for heart disease, and who may benefit from proven interventions such as cholesterol and blood pressure management, working toward a healthy BMI and smoking cessation, although more work is needed.
Data for this study comes from the Coronary Artery Risk Development in Young Adults (CARDIA) Study, a longitudinal, community-based study that recruited 5,115 black and white adults ages 18-30 in four cities - Oakland, California; Minneapolis; Chicago; and Birmingham, Alabama - beginning in 1985 and followed them for 30 years. CT scans were performed on 3,330 subjects for the CAC study, and the mean follow-up period was 12.5 years. CAC of any amount was seen in 30 percent of that group. Investigators sought to answer two primary questions: can the simple presence of CAC on a chest CT inform clinical practice? And is a CAC score greater than 100 associated with premature death? The answer to both was yes. "The presence of any coronary artery calcification, even the lowest score, was associated with between a 2.6 and tenfold increase in clinical events over the next 12.5 years. And when it comes to those with high CAC scores (100 or above), the incidence of death was 22 percent, or approximately 1 in 5. Very few times do you get a biomarker, be it genetic or imaging, that predicts death at a level of 22 percent over 12.5 years."