Author + information
- Amjad M. Ahmed,
- Ihab Sulaiman,
- Dalia Ahmed,
- Mousa Alfaris,
- Misfer Aldosari,
- Ahmed Aljizeeri,
- Ahmed Alsaileek,
- Abdulbaset Sulaiman,
- Sherif Sakr and
- Mouaz Al-Mallah
Introduction: Coronary artery calcium (CAC) score and hyperaemic myocardial blood flow (HMBF) have been associated with clinical outcomes. The aim of this analysis is to determine the incremental prognostic value of CAC over HMBF in the prediction of cardiac events.
Methods: A total of 2,060 consecutive patients with suspected coronary artery disease underwent 82Rubidium myocardial perfusion imaging (MPI) positron emission tomography (PET) and CAC scan in the same setting. Patients were followed up for major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, admission for unstable angina and late revascularizations. Multiple nested Cox model were used to determine the incremental prognostic value of CAC.
Results: At baseline, HMBF decreased (3.6±1.6, 3.3 ± 1.4, and 2.7±1.4, p<0.0001) with increasing levels of CAC (0, 1 to 399, and ≥400). Over a median of 1.35 years (interquartile range: 0.64 to 2.77), there were 87 MACE. The annual risk-adjusted MACE rates increased with increasing CAC (1.0%, 3.0%, and 8.2% per year for CAC of 0, 1 to 399, and ≥400, respectively; p<0.0001). Cox proportional hazards analysis revealed that CAC improved model fit, risk discrimination, and risk reclassification over clinical risk and HMBF. (Table)
Conclusions: In symptomatic patients undergoing 82Rubidium myocardial perfusion imaging, HMBF and CAC provides incremental risk assessment over clinical risk score for prediction of major adverse cardiac events.
Moderated Poster Contributions
Non Invasive Imaging Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 4:15 p.m.-4:25 p.m.
Session Title: Imaging With Cardiac CT: The Case for Calcium
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1176M-07
- 2017 American College of Cardiology Foundation