Age-Stratified Coronary Artery Calcium Levels Quantification Based on Arterial Biomechanical Parameters*

Abstract

Coronary Artery Calcium (CAC) constitutes a highly specific feature of ‘coronary’ atherosclerosis. The aim of this study is to explore the combination of arterial biomechanical parameters, used for general atherosclerosis evaluation, in CAC score assessment, stratified by year of age. Three hundred and fifty individuals participated in the study, with no history of cardiovascular disease. CAC score jointly with ascending aortic diameter (AAD) were determined through multislice computer tomography. Carotid intima-media thickness (cIMT) and presence of carotid and femoral plaques (PAB) were also assessed using B-mode ultrasound. Aortic stiffness was calculated by means of Pulse Wave Velocity (aPWV). Data were grouped by age, thus becoming a stratification factor. Univariate and multiple linear regression (MLR) analysis were applied for CAC score quantification. Univariate analysis evidenced a linear association between log-transformed levels of CACs stratified by age (LCACs) and aPWV (R2=0.43, P<0.05), cIMT (R2=0.52, P<0.05), AAD (R2=0.53, P<0.05), PAB (R2=0.46, P<0.05) and SBP (R2=0.10, P<0.05). An adjusted determination coefficient (adj. R2) of 0.89 was obtained for MLR, where AAD, cIMT, PAB, SBP and BMI were significantly correlated with LCACs (P<0.05). This analysis provides a holistic description in terms of the contribution of atherosclerosis/arteriosclerosis markers (such as cIMT and aortic diameters) that may suggest the existence of increased levels of age-stratified CAC.