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Coronary artery calcium has been shown to be the most powerful predictor of future cardiovascular events. We aimed to evaluate the prognostic value of increasing CAC scores for predicting future coronary events.
This study includes 319 asymptomatic individuals with CAC score >10 at baseline. Each participant underwent 2 CAC scans performed at least 1 year apart. Progression of CAC was annualized (%change/year). We evaluated the prognostic value of CAC score progression according to baseline CAC scores categories (10-100, 100-400, 400-1,000 and >1,000) and annual CAC score change (<10%, 10-15%, 15-20% and >20% CAC score change/year). The patients were followed for the occurrence of adverse future coronary events defined as non-fatal myocardial infarctions, coronary bypass, coronary angioplasty and ischemic cerebrovascular events.
Mean follow up duration was 3 years (range 1-7 years). There were a composite of 34 events in 23 patients. CAC progression was significantly higher in patients with cardiac events compared with those without events (35% vs. 22%, p=0.04). An annual increase of >10%/year of CAC scores was associated with odds ratio of 2.6 (95% confidence interval: 1.0,6.7; p <0.05) in patients with baseline CAC score>100. The risk increased 3.3 fold with increasing baseline CAC scores>400 (95% Cl 1.1, 10.0, p=0.037) and 3.8 fold increasing annual CAC score change>20% (95% Cl 1.1,13.6, p=0.039). The results were adjusted for age, gender and traditional cardiac risk factors and statin use. Among risk factors age (OR=1.1, 95%CI 1.1,1.2, p=0.046) and gender (OR=4.6, 95% Cl 1.1,19.6, p=0.04) were found to be predictors of adverse future coronary events. No patients with lack of CAC progression (no change or decrease) suffered coronary events.
This study shows significant CAC progression to be a strong predictor of future coronary events.
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-355
- 2013 American College of Cardiology Foundation