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SAVED and SOLVED trials showed Angiotensin converting enzyme inhibitors (ACEI) decrease cardiovascular (CV) mortality rate in low Ejection fraction (EF) patients, however PEACE and EUROPA trials didn't show significant similar preventive effects in normal EF group. We evaluated baseline coronary artery calcium (CAC) score as a predictor of the ACEI use effect on outcomes among normal EF participants.
4,208 who never used ACEI or were using ACEI (n=368, 8.7%) during all baseline and follow up examinations out of 6,814 the Multi Ethnic Study for Atherosclerosis (MESA) population were enrolled. Population (53.9% male) aged 60.8± 10.0 years (45-84) had no apparent clinical CV Disease. We compared CV event rates and multivariable-adjusted hazard ratios after stratifying by ACEI use and CAC (0, 1 to < 400 and > = 400).
The event rates varied from 1.8 to 41.2 per 1,000 person years among the groups (see Table 1.) Among participants with 1 to <400 CAC score, ACEI users compare to non ACEI users showed significantly lower event rate (8.2 vs. 4.9, in order). Hazard ratio in adjusted model was 3.1 (Cl= 95%; 1.13, 8.78, P<0.05). There was no significant event rate difference between ACEI users and non users among other CAC groups.
The use of ACEI was associated with significantly less CV events in patients with low to intermediate CAC scores and normal EF. CAC scores should be considered to evaluate the need for further CV risk reduction interventions in asymptomatic persons.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality V
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1228M-353
- 2013 American College of Cardiology Foundation