Epidemiology of Coronary Artery Calcification
Condition: Cardiovascular Diseases; Atherosclerosis; Coronary Arteriosclerosis; Heart Diseases; Coronary Disease
MeSH terms: Cardiovascular Diseases; Heart Diseases; Atherosclerosis; Coronary Disease; Coronary Artery Disease; Arteriosclerosis; Myocardial Ischemia
Study type: Observational

Summary: 
      Using subjects from the Rochester Family Heart Study (RFHS), to characterize predictors of
      coronary artery calcification (CAC), a potent marker of atherosclerosis, among individuals
      from the general population.
    

Detailed description: 
      BACKGROUND:

      Coronary artery disease (CAD) is a major cause of mortality and morbidity in the United
      States. Current noninvasive methods to identify individuals with atherosclerosis, such as
      exercise testing, are often insensitive until plaques have progressed enough to significantly
      impede blood flow or impair myocardial function. A large number of individuals destined to
      die suddenly or to experience myocardial infarction will experience no warning symptoms,
      having only mild non-flow limiting lesions which rupture and cause occlusive clot. Since
      coronary artery calcification (CAC) can identify individuals with mild, non-flow limiting
      lesions, CAC is a potent marker of atherosclerosis. The presence of calcium in mild, non-flow
      limiting lesions is hypothesized to be a predictor of coronary events in asymptomatic adults.
      Ultrafast Cardiac Computed Tomography (Ultrafast CT) provides a tool to obtain sensitive,
      noninvasive measures of both the presence and quantity of CAC.

      DESIGN NARRATIVE:

      Beginning in 1991, the study sought to establish if age and gender predict coronary artery
      calcification, a potent marker of atherosclerosis, in individuals who were sampled by the
      RFHS and who reported no symptoms of coronary artery disease. The study also sought to
      establish: if measures of lipid metabolism provide additional information in predicting CAC
      after accounting for variation in age and gender; if measures of blood pressure, body size,
      fat distribution, or smoking predict CAC after accounting for variation in age, gender, and
      measures of lipid metabolism; if the quantity of CAC aggregates in families; whether the
      predictors of CAC in asymptomatic individuals differ from predictors in those with symptoms
      of coronary artery disease. Ultrafast Cardiac Computed Tomography (Ultrafast CT) was used to
      obtain sensitive, noninvasive measures of both the presence and quantity of CAC.

      The study was renewed in 2001 through February 2005 to: determine whether CAC predicts
      clinical events after 7.5 years of active followup; identify genetic determinants of change
      in CAC quantity; assess whether these genes act through measurable coronary artery disease
      risk factors. The full sample of 1,647 asymptomatic at baseline adults will be followed
      prospectively for clinical endpoints, while CAC quantity will be re-evaluated in a sub sample
      of 1,000 individuals.

      The influence of newer inflammatory markers such as fibrinogen, C-reactive protein and
      antibodies to infective agents will be evaluated.
    

Observational model: Ecologic or Community
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        817 men and 830 women ages 20 and older recruited from Rochester, MN.