Derivation of a coronary age calculator using traditional risk factors and coronary artery calcium: The multi-ethnic study of atherosclerosis

Michael J. Blaha, Isaac N. Naazie, Miguel Cainzos-Achirica, Zeina A. Dardari, Andrew P. Defilippis, Robyn L. McClelland, Mohammadhassan Mirbolouk, Olusola A. Orimoloye, Omar Dzaye, Khurram Nasir, John H. Page

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


BACKGROUND: The optimal method for communicating coronary heart disease (CHD) risk to individual patients is not yet clear. Recent research supports the concept of "coronary age" for more effective risk communication. We defined an individual’s coronary age as the age at which an average healthy individual would have an equivalent estimated CHD risk as that calculated for the index individual, building on our previously validated MESA (Multi-Ethnic Study of Atherosclerosis) 10-year CHD Risk Score equations with and without coronary artery calcium (CAC). METHODS AND RESULTS: We derived a coronary age by (1) calculating the MESA 10-year CHD risk; (2) mathematically setting this equal to an equation describing risk of an average healthy MESA participant, as a function of age; and (3) solving for age. The risk discrimination of the resultant coronary age was compared with that of chronological age, the MESA CHD Risk Score, and CAC alone. Approximately 95% of coronary age values ranged from 30 years less to 30 years higher than chronological age. Although the mean chronological age of individuals experiencing CHD events compared with those free of events was 67.4 versus 61.8 years, the difference in coronary age including CAC was larger (80.6 versus 62.8 years). Coronary age with CAC had identical predictive ability to that of MESA CHD Risk Score and outperformed chronological age and CAC alone. CONCLUSIONS: The newly derived coronary age is a convenient transformation of MESA CHD Risk, retaining very good risk discrimination. This easy-to-communicate tool will be available for patients and clinicians, potentially facilitating risk communication in routine care.

Original languageEnglish (US)
Article numbere019351
Pages (from-to)e019351
JournalJournal of the American Heart Association
Issue number6
StatePublished - Mar 16 2021


  • Atherosclerosis
  • Cardiovascular disease
  • Coronary age
  • Coronary artery calcium
  • Risk communication
  • Risk prediction
  • Prospective Studies
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Male
  • Incidence
  • Calcium/metabolism
  • United States/epidemiology
  • Time Factors
  • Aged, 80 and over
  • Female
  • Risk Assessment/methods
  • Coronary Angiography/methods
  • Severity of Illness Index
  • Risk Factors
  • Coronary Artery Disease/diagnosis
  • Atherosclerosis/diagnosis
  • Ethnicity
  • Aged
  • Coronary Vessels/diagnostic imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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