{"doi":"10.1016/j.jacc.2021.08.019","title":"Modeling the Recommended Age for Initiating Coronary Artery Calcium Testing Among At-Risk Young Adults","abstract":"BACKGROUND: There are currently no recommendations guiding when best to perform coronary artery calcium (CAC) scanning among young adults to identify those susceptible for developing premature atherosclerosis. OBJECTIVES: The purpose of this study was to determine the ideal age at which a first CAC scan has the highest utility according to atherosclerotic cardiovascular disease (ASCVD) risk factor profile. METHODS: We included 22,346 CAC Consortium participants aged 30-50 years who underwent noncontrast computed tomography. Sex-specific equations were derived from multivariable logistic modeling to estimate the expected probability of CAC >0 according to age and the presence of ASCVD risk factors. RESULTS: Participants were on average 43.5 years of age, 25% were women, and 34% had CAC >0, in whom the median CAC score was 20. Compared with individuals without risk factors, those with diabetes developed CAC 6.4 years earlier on average, whereas smoking, hypertension, dyslipidemia, and a family history of coronary heart disease were individually associated with developing CAC 3.3-4.3 years earlier. Using a testing yield of 25% for detecting CAC >0, the optimal age for a potential first scan would be at 36.8 years (95% CI: 35.5-38.4 years) in men and 50.3 years (95% CI: 48.7-52.1 years) in women with diabetes, and 42.3 years (95% CI: 41.0-43.9 years) in men and 57.6 years (95% CI: 56.0-59.5 years) in women without risk factors. CONCLUSIONS: Our derived risk equations among health-seeking young adults enriched in ASCVD risk factors inform the expected prevalence of CAC >0 and can be used to determine an appropriate age to initiate clinical CAC testing to identify individuals most susceptible for early/premature atherosclerosis.","journal":"Journal of the American College of Cardiology","year":2021,"id":154132,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":65,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.961,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":339079,"name":"Alexander C. Razavi","orcid":"0000-0002-3213-0876","position":1,"is_corresponding":false},{"id":284561,"name":"Zeina Dardari","orcid":"0000-0001-6026-3329","position":2,"is_corresponding":false},{"id":235805,"name":"Leslee J. Shaw","orcid":"0000-0003-1268-1491","position":3,"is_corresponding":false},{"id":253731,"name":"Daniel S. Berman","orcid":"0000-0002-3793-9578","position":4,"is_corresponding":false},{"id":24934,"name":"Matthew J. Budoff","orcid":"0000-0002-9616-1946","position":5,"is_corresponding":false},{"id":276020,"name":"Michael D. Miedema","orcid":"0000-0003-0499-5810","position":6,"is_corresponding":false},{"id":74982,"name":"Khurram Nasir","orcid":"0000-0001-5376-2269","position":7,"is_corresponding":false},{"id":276022,"name":"Alan Rozanski","orcid":"0000-0002-7278-4890","position":8,"is_corresponding":false},{"id":276021,"name":"John A. Rumberger","orcid":"0000-0001-5018-2832","position":9,"is_corresponding":false},{"id":244156,"name":"Carl E. Orringer","orcid":null,"position":10,"is_corresponding":false},{"id":35952,"name":"Sidney C. Smith","orcid":"0000-0003-0480-0454","position":11,"is_corresponding":false},{"id":235807,"name":"Ron Blankstein","orcid":"0000-0002-8393-6562","position":12,"is_corresponding":false},{"id":284560,"name":"Seamus P. Whelton","orcid":"0000-0001-5914-0735","position":13,"is_corresponding":false},{"id":236227,"name":"Martin Bødtker Mortensen","orcid":"0000-0003-2693-4154","position":14,"is_corresponding":false},{"id":71977,"name":"Michael J. Blaha","orcid":"0000-0001-5138-9683","position":15,"is_corresponding":false},{"id":236228,"name":"Omar Dzaye","orcid":"0000-0001-9483-3510","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-18T23:43:49.684414Z","pmid":"34649694","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}