Progression of calcified coronary atherosclerosis: relationship to coronary risk factors and carotid intima-media thickness

Atherosclerosis. 2008 Mar;197(1):339-45. doi: 10.1016/j.atherosclerosis.2007.05.027. Epub 2007 Aug 28.


Background: The determinants of coronary artery calcium (CAC) progression are not well understood. Prior studies have shown a limited relationship between CAC progression and traditional coronary risk factors. We hypothesized that the extent of non-calcified atherosclerosis detected using carotid intima-media thickness (CIMT) would predict progression of calcified atherosclerosis.

Methods: One hundred and eighty healthy male participants (mean age 47.9) with CAC from the Prospective Army Coronary Calcium (PACC) project volunteered to undergo a second EBCT scan, risk factor assessment, lab testing, and CIMT assessment 4.2+/-1.3 years after their original scan. All results were independently examined, blinded to baseline data. A change in CAC score >or=15% per year was defined as clinically significant progression.

Results: CAC progression occurred in 60.2%. Compared to participants without progression, those with progression had higher triglycerides, LDL and total cholesterol and Framingham risk scores, but similar blood pressure, HDL cholesterol, blood glucose, C-reactive protein, fibrinogen, and body mass index. CIMT was significantly higher among those with versus without CAC progression (0.660 mm versus 0.603 mm; P=0.001). Each quintile of increasing CIMT was independently associated with a 35% increase in the odds of CAC progression (P=0.01), after controlling for the Framingham risk score and C-reactive protein.

Conclusion: Among middle-aged men with coronary calcium, increasing extent of non-calcified atherosclerosis is strongly associated with coronary artery calcium progression over 4 years.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Calcinosis / epidemiology*
  • Calcinosis / pathology*
  • Carotid Arteries / pathology
  • Carotid Artery Diseases / epidemiology
  • Carotid Artery Diseases / pathology
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / pathology*
  • Coronary Vessels / pathology
  • Disease Progression
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Tunica Intima / pathology
  • Tunica Media / pathology