PMID- 37534563 OWN - NLM STAT- MEDLINE DCOM- 20230823 LR - 20240902 IS - 1930-739X (Electronic) IS - 1930-7381 (Print) IS - 1930-7381 (Linking) VI - 31 IP - 9 DP - 2023 Sep TI - Cardiovascular risk stratification among individuals with obesity: The Coronary Artery Calcium Consortium. PG - 2240-2248 LID - 10.1002/oby.23832 [doi] AB - OBJECTIVE: The effectiveness of coronary artery calcification (CAC) for risk stratification in obesity, in which imaging is often limited because of a reduced signal to noise ratio, has not been well studied. METHODS: Data from 9334 participants (mean age: 53.3 +/- 9.7 years; 67.9% men) with BMI >/= 30 kg/m(2) from the CAC Consortium, a retrospectively assembled cohort of individuals with no prior cardiovascular diseases (CVD), were used. The predictive value of CAC for all-cause and cause-specific mortality was evaluated using multivariable-adjusted Cox proportional hazards and competing-risks regression. RESULTS: Mean BMI was 34.5 (SD 4.4) kg/m(2) (22.7% Class II and 10.8% Class III obesity), and 5461 (58.5%) had CAC. Compared with CAC = 0, those with CAC = 1-99, 100-299, and >/=300 Agatston units had higher rates (per 1000 person-years) of all-cause (1.97 vs. 3.5 vs. 5.2 vs. 11.3), CVD (0.4 vs. 1.1 vs. 1.5 vs. 4.2), and coronary heart disease (CHD) mortality (0.2 vs. 0.6 vs. 0.6 vs. 2.5), respectively, after mean follow-up of 10.8 +/- 3.0 years. After adjusting for traditional cardiovascular risk factors, CAC >/= 300 was associated with significantly higher risk of all-cause (hazard ratio [HR]: 2.05; 95% CI: 1.49-2.82), CVD (subdistribution HR: 3.48; 95% CI: 1.81-6.70), and CHD mortality (subdistribution HR: 5.44; 95% CI: 2.02-14.66), compared with CAC = 0. When restricting the sample to individuals with BMI >/= 35 kg/m(2) , CAC >/= 300 remained significantly associated with the highest risk. CONCLUSIONS: Among individuals with obesity, including moderate-severe obesity, CAC strongly predicts all-cause, CVD, and CHD mortality and may serve as an effective cardiovascular risk stratification tool to prioritize the allocation of therapies for weight management. CI - (c) 2023 The Authors. Obesity published by Wiley Periodicals LLC on behalf of The Obesity Society. FAU - Boakye, Ellen AU - Boakye E AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Grandhi, Gowtham R AU - Grandhi GR AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Dardari, Zeina AU - Dardari Z AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Adhikari, Rishav AU - Adhikari R AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Soroosh, Garshasb AU - Soroosh G AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Jha, Kunal AU - Jha K AD - Division of Cardiovascular Medicine, University of Louisville, Louisville, Kentucky, USA. FAU - Dzaye, Omar AU - Dzaye O AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Tasdighi, Erfan AU - Tasdighi E AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Erhabor, John AU - Erhabor J AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Kumar, Sant J AU - Kumar SJ AD - Department of Medicine, MedStar Georgetown University Hospital, Washington, DC, USA. FAU - Whelton, Seamus AU - Whelton S AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Blumenthal, Roger S AU - Blumenthal RS AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. FAU - Albert, Michael AU - Albert M AD - University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. FAU - Rozanski, Alan AU - Rozanski A AD - Division of Cardiology, Mount Sinai, St. Luke's Hospital, New York, New York, USA. FAU - Berman, Daniel S AU - Berman DS AD - Departments of Imaging and Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA. FAU - Budoff, Matthew J AU - Budoff MJ AD - Lundquist Institute, Harbor-UCLA Medical Center, Torrance, California, USA. FAU - Miedema, Michael D AU - Miedema MD AD - Minneapolis Heart Institute and Foundation, Minneapolis, Minnesota, USA. FAU - Nasir, Khurram AU - Nasir K AD - Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA. FAU - Rumberger, John A AU - Rumberger JA AD - Department of Cardiac Imaging, Princeton Longevity Center, Princeton, New Jersey, USA. FAU - Shaw, Leslee J AU - Shaw LJ AD - Department of Radiology, Weill Cornell Medicine, New York, New York, USA. FAU - Blaha, Michael AU - Blaha M AUID- ORCID: 0000-0001-5138-9683 AD - Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. LA - eng GR - L30 HL110027/HL/NHLBI NIH HHS/United States GR - T32 HL007227/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20230803 PL - United States TA - Obesity (Silver Spring) JT - Obesity (Silver Spring, Md.) JID - 101264860 RN - SY7Q814VUP (Calcium) SB - IM MH - Male MH - Humans MH - Adult MH - Middle Aged MH - Female MH - *Cardiovascular Diseases/etiology MH - Calcium MH - Retrospective Studies MH - Coronary Vessels/diagnostic imaging MH - Risk Factors MH - Risk Assessment MH - *Vascular Calcification/diagnostic imaging/complications MH - *Coronary Artery Disease/etiology MH - Obesity/complications MH - Heart Disease Risk Factors PMC - PMC10524261 MID - NIHMS1903160 COIS- Disclosures: The authors declared no conflict of interest. EDAT- 2023/08/03 06:43 MHDA- 2023/08/23 06:42 PMCR- 2024/09/01 CRDT- 2023/08/03 05:39 PHST- 2023/04/24 00:00 [revised] PHST- 2023/03/01 00:00 [received] PHST- 2023/05/16 00:00 [accepted] PHST- 2023/08/23 06:42 [medline] PHST- 2023/08/03 06:43 [pubmed] PHST- 2023/08/03 05:39 [entrez] PHST- 2024/09/01 00:00 [pmc-release] AID - 10.1002/oby.23832 [doi] PST - ppublish SO - Obesity (Silver Spring). 2023 Sep;31(9):2240-2248. doi: 10.1002/oby.23832. Epub 2023 Aug 3.