Biomarkers · Cardiac & Hemodynamics
Coronary Artery Calcium Score (Agatston)
Lower values go with lower risk of death. No risk curve catalogued yet.
Published risk of death3.23×CAC > 0 vs CAC = 0, asymptomatic population (95% CI 2.12–4.93) · Meta-analysis of 45 cohort studies without established CAD (192,080 asymptomatic, 32,477 symptomatic); estimate for asymptomatic arm
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| pharmacologic | Protocol-adherent cinacalcet with low-dose vitamin D (<=6 ug/week paricalcitol equivalent) for 52 weeks vs flexible-dose vitamin D sterols alone in haemodialysis patients with secondary hyperparathyroidism | Median Agatston CAC progression 17.8% vs 31.3% with vitamin D alone over 52 weeks (P = 0.02) | RCT | Ureña-Torres PA, et al. Nephrology, dialysis, transplantation : official… |
| supplement | Calcium carbonate (1000 mg elemental calcium) plus vitamin D3 400 IU daily for a mean 7 years in postmenopausal women aged 50-59 at randomization (WHI substudy) | Mean CAC score 91.6 with calcium/vitamin D vs 100.5 with placebo after a mean of 7 years (rank test P = 0.74; no significant difference) | RCT | Manson JE, et al. Menopause (New York, N.Y.). 2010. Calcium/vitamin D… |
| supplement | Menaquinone-7 360 ug daily for 2 years in patients with symptomatic coronary artery disease and CAC 50-400 AU | Median CAC rose from 135 to 184 AU with MK-7 vs 145 to 214 AU with placebo over 2 years (between-group P = .02) | RCT | Vossen LM, et al. JAMA cardiology. 2026. Two Years of Menaquinone-7… |
What else moves this marker
They describe those study groups, not an individual, and an association is not a cause.
Genetic predisposition
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↑ APOB p.Arg3527Gln · carriers vs non-carriers of the missense variant | ratio 4 | APOB p.Arg3527Gln carriers vs non-carriers · European- and African-ancestry adults with CAC by cardiac CT, CHARGE Consortium | meta analysis · PMID 27872105 |
| ↓ APOE e2 allele (p.Arg176Cys) · e2 carriers vs non-carriers | -22.3% | APOE e2 carriers vs non-carriers · European- and African-ancestry adults with CAC by cardiac CT, CHARGE Consortium | meta analysis · PMID 27872105 |
Environmental and occupational exposures
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↑ Former cigarette smoking (>30 years since quitting) · people who formerly smoked, more than 30 years after cessation, vs people who never smoked | +19% | former smokers >30 years after quitting vs never smokers · Adults from 22 cohorts of the Cross Cohort Collaboration (mean age 58.2 years, 69% female) | prospective cohort · PMID 40074467 |