Physicians' Academy for Cardiovascular Education

CAC measurements predict HFpEF risk in women

Usefulness of Coronary Artery Calcium to Predict Heart Failure with Preserved Ejection Fraction in Men Versus Women (From the Multi-Ethnic Study of Atherosclerosis)

Sharma K, Al Rifai M, Ahmed HM, et al. - Am J of Cardiol 2017; published online ahead of print


The prevalence of HFpEF is increasing, affecting more women than men, and treatment options for this condition are limited [1,2]. The pathophysiology of HFpEF is complex, and efforts are made to target subgroups of patients with specific characteristics, who may need individual therapeutic approaches [3]. CAD is associated with elevated HFpEF risk, and HFpEF is seen in up to half of patients. Since CAC is a marker of coronary atherosclerosis [4], CAC measurements might be useful to identify individuals at high-risk for HFpEF, before they develop clinically overt CAD.

This analysis of the MESA study evaluated whether assessing CAC is helpful for the identification of patients at higher risk for HFpEF. Moreover, it was assessed whether the potential association between CAC and the risk of HFpEF is influenced by gender.

The MESA study recruited 6814 asymptomatic men and women without clinical CVD, aged 45-84 years, between 2000 and 2002 in the US. At baseline, each participant was assessed for the presence of CAC. All participants were scanned twice, and the average Agatston score was calculated and used for all analyses [5].

Main results


In asymptomatic individuals without clinical CVD, the measurement of CAC was associated with the risk of HFpEF in women and may therefore be helpful for the risk stratification of HFpEF in women. These findings suggest that CAC may be used to identify and introduce appropriate preventive measures for women at high risk of HFpEF.


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Find this article online at Am J Cardiol