Gender and age effects on risk factor-based prediction of coronary artery calcium in symptomatic patients: A Euro-CCAD study

- Coronary artery calcification (CAC) prevalence among females lagged males by around 10 years.
- Age, dyslipidaemia, hypertension, diabetes and smoking were independently predictive of CAC presence in both genders.
- The most important predictors were dyslipidaemia and diabetes in males and diabetes and smoking in females.
- There was no difference in the predictive ability of these risk factors between genders in patients aged ≤70 years.
- In males aged >70 only dyslipidaemia predicted CAC presence, while in females only smoking and diabetes were predictive.

Background and aimsThe influence of gender and age on risk factor prediction of coronary artery calcification (CAC) in symptomatic patients is unclear.MethodsFrom the European Calcific Coronary Artery Disease (EURO-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62% male, from Denmark, France, Germany, Italy, Spain and USA. All of them underwent risk factor assessment and CT scanning for CAC scoring.ResultsThe prevalence of CAC among females was lower than among males in all age groups. Using multivariate logistic regression, age, dyslipidaemia, hypertension, diabetes and smoking were independently predictive of CAC presence in both genders. In addition to a progressive increase in CAC with age, the most important predictors of CAC presence were dyslipidaemia and diabetes (β = 0.64 and 0.63, respectively) in males and diabetes (β = 1.08) followed by smoking (β = 0.68) in females; these same risk factors were also important in predicting increasing CAC scores. There was no difference in the predictive ability of diabetes, hypertension and dyslipidaemia in either gender for CAC presence in patients aged <50 and 50-70 years. However, in patients aged >70, only dyslipidaemia predicted CAC presence in males and only smoking and diabetes were predictive in females.ConclusionsIn symptomatic patients, there are significant differences in the ability of conventional risk factors to predict CAC presence between genders and between patients aged <70 and ≥70, indicating the important role of age in predicting CAC presence.