High CAC score linked to increased risk of cancer, CKD, and COPD

John Murphy, MDLinx | March 18, 2016

Patients with elevated coronary artery calcium (CAC) score are not only at increased risk of cardiovascular disease but also at greater risk of cancer, chronic kidney disease, and chronic obstructive pulmonary disease (COPD), according to a study published online on March 9, 2016 in the Journal of the American College of Cardiology: Cardiovascular Imaging.


elevated coronary artery calcium (CAC) linked to cancer risk

High coronary artery calcium (CAC) score, as assessed by cardiac CT scan, is associated not only with cardiovascular disease but with other chronic diseases. (Photo: Johns Hopkins University)

The other important finding of this 10-year, multicenter study was that people with a CAC score of 0 seem to be protected from CVD and other chronic diseases, researchers noted.

“Plaque in the arteries is the result of cumulative damage and inflammation, and vulnerability to injury and chronic inflammation likely contributes to diseases like cancer, kidney, and lung diseases, as well as cardiovascular disease. So it makes sense that the coronary calcium score—a measure of arterial aging—is predictive of non-cardiovascular diseases, too,” said Michael Blaha, MD, MPH, Director of Clinical Research for the Ciccarone Center for the Prevention of Heart Disease and Assistant Professor of Medicine at the Johns Hopkins University School of Medicine, in Baltimore, MD.

“The reason the coronary calcium score may work so well at identifying vulnerability to a variety of chronic diseases is because it’s a direct measurement of the cumulative effect of all risk factors, rather than a consideration of a single risk factor, like obesity, smoking, or high blood pressure,” he said.

The research team for this study included investigators from Johns Hopkins, the University of California Los Angeles, the Henry Ford Hospital in Detroit, the Minneapolis Heart Institute, and Columbia University in New York. They used data from 6 centers that contributed subjects to the Multi-Ethnic Study of Atherosclerosis (MESA).

The researchers included 6,814 participants, ages 45 to 84, and calculated their baseline CAC scores using cardiac CT scans. Subjects underwent follow-up visits at least once a year for about 10 years.

By the end of the study period, 1,238 of the 6,814 original subjects had been diagnosed with a non-cardiovascular disease—11% had a CAC score of 0 and about 37% had a CAC score greater than 400.

After adjusting for various factors, the researchers found that participants with CAC scores greater than 400 had:

  • 53% increased risk of cancer
  • 70% increased risk of chronic kidney disease
  • 271% increased risk of chronic obstructive pulmonary disease (COPD)

The researchers reported slight associations between CAC scores and dementia and hip fractures, and no association with blood clots or pneumonia after adjusting for factors such as age, sex, race, income, and health insurance status.

Results also showed that half of all participants had a CAC score of 0. “These ‘healthy agers’ are at very low risk of CVD and non-CVD morbidity and mortality,” the authors wrote. “There are broad implications to identifying and studying such people in the population.”