Author + information
- Yoav Arnson,
- Alan Rozanski,
- Heidi Gransar,
- Sean Hayes,
- Yuka Otaki,
- Mhairi Doris,
- Frances Wang,
- John Friedman,
- Louise Thomson,
- Balaji Tamarappoo,
- Piotr Slomka,
- Damini Dey and
- Daniel Berman
Background: Coronary artery calcium (CAC) score is a marker of coronary atherosclerosis with increasing prevalence as a function of age; however, the prevalence and prognostic implications of CAC scanning in elderly patients are not well defined.
Methods: We studied 1028 consecutive asymptomatic patients aged 75 and older who underwent CAC scanning in our institution between 1998 and 2012. Medical history, height, weight and blood pressure, and measured lipid and glucose values were collected. Mortality data were obtained 5.3 (IQR 2.1-8.1) years after testing, with a minimum follow-up of one year. Patients were divided into 3 age groups (75-80,81-85 and ≥ 86), CAC scores were categorized as 0-9, 100-399, and ≥400.
Results: Of the 1028, 45.8% were male. CAC was present in 91.2% of the population. The median CAC score was 181 (IQR 24-605) for women and 598 (IQR 160-598) for men. The median CAC score was 272 for ages 75-80, 426 for ages 81-85 and 644 for patients older than 85. The prevalence of CAC score under 10 was 16.5%, 9.5% and 6.2% and CAC score over 400 was present in 41.5%, 52.2% and 58.9%, of those age groups, respectively. During the study period, 28.8% of the patients died (30.4% of men, 27.3% of women, p=0.36). The use of traditional risk factors to stratify mortality risk was not additive to the patients age. CAC score, however, was highly associated with mortality. Mortality in the group of CAC score 0-9 was 18.3%, compared with 26% and 33.7% for CAC 10-399 and CAC >399, respectively, P=0.003. After adjustment for age and cardiovascular risk factors, CAC remained highly predictive of mortality. For every increase of log (CAC), adjusted mortality rates increased by 1.29 (95% CI 1.02-1.65; p=0.018). A CAC score under 10 was associated with a reduced mortality risk. Compared with the low CAC score patient group, the adjusted risk for patients with CAC scores of 10-399 and >399 was 2.2 (95% CI 1.12-4.3) and 3.01 (95% CI 1.52-5.96), respectively.
Conclusions: High CAC scores are highly prevalent in patients over 75 years old and are associated with increased mortality. CAC scores <10 are not common, but when present, indicate an excellent prognosis.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: Coronary Calcium Scoring and CV Risk Assessment
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1198-234
- 2017 American College of Cardiology Foundation