Key result
CAC score >=400 predicts increased MACE in stable CAD.
Why the study?
Coronary artery calcium scoring is useful for risk stratification, but its relationship with major adverse cardiovascular outcomes needed evaluation in patients with stable coronary artery disease.
Does a high coronary artery calcium score (≥ 400) predict major adverse cardiovascular events in patients with stable ischemic heart disease?
Cohort (n=435)
No
Does a high coronary artery calcium score (≥ 400) predict major adverse cardiovascular events in patients with stable ischemic heart disease?
Effect estimate: OR 1.007 (95% CI 1.005-1.009)
p-value: p=0.001
A coronary artery calcium score of 400 or higher is an independent predictor of major adverse cardiovascular events in patients with stable ischemic heart disease over a 2-year period.
High CACS may aid risk stratification in stable CAD; leaves open its incremental value for guiding therapy.
BACKGROUND: Coronary artery atherosclerosis and calcification are the precursors to the development of coronary artery disease and its complications. Coronary artery calcium scoring (CACS) is useful as a risk-stratification tool in coronary artery disease. OBJECTIVE: The current study was designed to identify the relationship between CACS and major adverse cardiovascular outcomes in patients with stable coronary artery disease. METHODS: The study was conducted on 435 patients with stable ischemic heart disease. The patients were classified into two groups according to their coronary artery calcium score (CACS): group I (n = 220 patients), whose calcium score was mild to moderate (< 400), and group II (n = 215 patients), whose calcium score was high (≥ 400). All patients were closely monitored for two years to assess major adverse cardiovascular events (MACE). RESULTS: After 2 years of follow-up, MACE drastically increased in Group II in the form of unstable angina, myocardial infarction, demand for percutaneous coronary intervention, and heart failure. Multivariate regression analysis showed that age ≥ 55 years, Framingham risk score > 10, CACS ≥ 400, body mass index ≥ 30 kg/m2, and the proximal lesions of the vessels were the independent risk factors for major cardiac events. CONCLUSION: The coronary calcium score is a distinct feature of coronary atherosclerosis, and a score of 400 or higher is a reliable, noninvasive predictor of the progression of coronary artery diseases and their consequences, including MACE.
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Elnagar et al. (2024) conducted a cohort in Stable coronary artery disease (n=435). High coronary artery calcium score (≥ 400) vs. Mild to moderate coronary artery calcium score (< 400) was evaluated on Major adverse cardiovascular events (MACE) (OR 1.007, 95% CI 1.005-1.009, p=0.001). A coronary artery calcium score of 400 or higher was an independent predictor of major adverse cardiovascular events (OR 1.007) in patients with stable coronary artery disease.
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