Coronary Artery Calcification and Total Mortality in Elderly Men

OBJECTIVES: To examine the relationship between coronary artery calcification (CAC) and mortality in a sample of elderly men. DESIGN: Prospective cohort study. SETTING: The Honolulu Heart Program. PARTICIPANTS: A population-based sample of 224 men aged 84 to 96 with good cognitive function. METHODS: From 2004 to 2005, subjects received physical examinations including CAC determinations. Participants were followed for up to 3 years for all-cause mortality. RESULTS: In the course of follow-up, there were 17 deaths (28.0/1,000 person-years). Risk of death rose consistently and significantly as CAC scores increased (P=.001). For CAC scores less than 10, no deaths were observed. For scores of 10 or higher, risk of death rose from 13.2 per 1,000 person-years for CAC scores of 10 to 100 to 48.6 per 1,000 person-years for CAC scores greater than 1,000. Findings persisted after adjusting for age and traditional risk factors. In this sample of elderly men, CAC was the only factor with a significant relationship with total mortality. CONCLUSION: Higher CAC scores in elderly men are associated with greater risk of death. Screening for CAC could be important for developing strategies to improve longevity in elderly people, particularly at an age when associations between mortality and traditional risk factors are weak.