Background: Little is known about the impact of coronary artery calcium (CAC) and its progression on cognitive function in midlife, a time of importance for cognitive aging.
Methods: In CARDIA, CAC was measured using computed tomography at years 15 (baseline), 20 and 25. CAC progression was defined as: (1) CAC>0 at follow-up among participants with baseline CAC = 0; (2) an annualized change of ≥10 units at follow-up among those with 0
Results: Among 2,341 participants (mean age 40.3 ± 3.6 years, 56% female, 43% Black at baseline), higher CAC score and CAC progression were associated with significantly lower cognitive performance in all cognitive tests. After adjustment for demographics, the association remained for CAC progression, compared to no progression, for most test scores: DSST (-2.70 95% CI: -4.05 to -1.36, p < 0.001), MoCA (-0.44 95% CI: -0.74 to -0.13, p = 0.005) and verbal fluency (-0.85 95% CI: -1.57 to -0.12, p = 0.02). Similar associations were observed for higher CAC score (>0 vs 0): DSST (-3.11 95% CI: -5.16 to -1.06, p = 0.003), MoCA (-0.81 95% CI: -1.28 to -0.34, p = 0.001) and RAVLT (-0.67 95% CI: -1.12 to -0.23, p = 0.003). Additional adjustment for physical activity, depressive symptoms, and APOE, and mutually for baseline CAC score and progression did not materially change the association.
Conclusions: CAC score and progression were associated with lower cognitive function in midlife. CAC progression may be an independent risk factor for early cognitive aging, independent of baseline CAC score and other risk factors.
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Methods: In CARDIA, CAC was measured using computed tomography at years 15 (baseline), 20 and 25. CAC progression was defined as: (1) CAC>0 at follow-up among participants with baseline CAC = 0; (2) an annualized change of ≥10 units at follow-up among those with 0
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Article Synopsis
- AI-CAC automated left atrial volumetry offers more actionable insights compared to traditional methods like the Agatston coronary artery calcium score, predicting atrial fibrillation (AF) as early as one year.
- The study evaluated the effectiveness of AI-CAC against human-measured left atrial volumes using cardiac magnetic resonance imaging (CMRI) in predicting AF and stroke, alongside established risk scores and biomarkers.
- Results showed that AI-CAC and CMRI provided similar predictive capabilities for AF and stroke over a 15-year period, indicating potential for AI-CAC in clinical settings, but further research is needed to confirm its utility.
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