Modeled age and interval for CAC detection in adults with elevated lipoprotein(a): Insights from MESA
Year: 2026
Type: article
Abstract: Structured Abstract Background Prior studies have examined coronary artery calcium (CAC) testing among individuals with elevated lipoprotein(a) [Lp(a]. However, the optimal timing of initial and repeat CAC testing remains uncertain. Objectives To determine the age of initial and repeat CAC testing (when baseline CAC=0) among individuals with Lp(a) >50 mg/dL. Methods Multi-Ethnic Study of Atherosclerosis (MESA) study participants with baseline Lp(a) were included. Multivariable logistic regression estimated modeled age with predicted probabilities of CAC>0 (at 15%, 20%, and 25% testing yield; number needed to screen [NNS] 6, 5, and 4 respectively) by sex, Lp(a) level and risk factor burden. Weibull survival models estimated time to incident CAC and time to repeat testing at similar testing yields. Results Of 6,700 MESA participants, 3,362 had baseline CAC=0. Men had earlier modeled time to CAC>0 than women. Among men with elevated Lp(a), earlier modeled ages for CAC testing were noted only in those with diabetes. Among women, earlier modeled ages for CAC testing were observed in those with elevated Lp(a) across all risk factors. The earliest testing ages were observed in men with elevated Lp(a) and diabetes + additional risk factor (25% yield: 33.4 years) and in women with elevated Lp(a) and high-risk factor burden (25% yield: 46.7 years). Among participants with baseline CAC=0, time to incident CAC>0 was shorter in participants with elevated versus non-elevated Lp(a) (4.2–5.8 vs. 4.5–6.2 years). Conclusion Although, earlier modeled ages for CAC testing were observed in those with elevated Lp(a) in men with diabetes and in women regardless of risk factor burden, the warranty period of CAC=0 was only modestly shorter in individuals with elevated Lp(a).
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,900
Awards: G1261793039, G1269631540, G1276754516, G1277265023, G1294553593, G1366832794, G1412221515, G1508663841, G1539384734, G1549676984, G1640378483, G1803853571, G1841396702, Wake Forest Clinical and Translational Science Award, G1859490047, G1912130661, G1983464145, G2095942735, G2144938473, G22458031, G2283629214, G2580996367, G2726417417, G2774420650, G2837638605, G290884426, G291913881, G3563251057, G3570589137, G3581052147, G3595232572, G3667269547, G3676546685, G3827449208, G3987397065, G4086764833, G4193201941, G4309390892, G4333854394, G4345352953, G4347835248, G4401650913, G4424626548, G4497505643, G4563812999, G4580880907, G4590187187, G4744199058, G4986157935, G5075046117, G5104865114, G5108002584, G514410172, G5653954166, G566787130, G5685980056, G5822583541, G5893636606, G5918866541, G5920463877, G5965568373, G6084644281, G6261335944, G6301523834, G6382156846, Institute for Clinical and Translational Research, G6443373778, G66341962, G6742279884, G6798586005, G6856766826, G693007907, G7166352866, G7220293292, G7327902224, G7335473956, G7443516602, G7462069030, G7756570238, G7844257601, G78770644, G7955059970, G805458286, Clinical and Translational Science Award, G8145863542, G842756795, G8638601890, G8761005068, G8852914737, Aspirin for Primary Prevention of Cardiovascular Disease in Patients with Elevated Lipoprotein(a), G991334795
OpenAlex ID: W7208826724