What is the clinical evidence from this study?

Study design: Observational. Population: Cardiovascular risk in asymptomatic individuals (n=25253). Intervention: Coronary artery calcium (CAC) score vs. CAC score of 0. Primary outcome: All-cause mortality (RR 12.5, p=<0.0001).

What question did this study set out to answer?

To develop risk-adjusted models incorporating CAC scores and risk factors for predicting all-cause mortality in asymptomatic patients.

June 21, 2026Journal of the American College of Cardiology

Long-Term Prognosis Associated With Coronary Calcification

Q: What are the key findings of this study?

Higher coronary artery calcium scores independently predicted all-cause mortality, with a 12.5-fold increased relative risk for scores >1,000 compared to a score of 0 (P<0.0001).

Q: What question did this study set out to answer?

To develop risk-adjusted models incorporating CAC scores and risk factors for predicting all-cause mortality in asymptomatic patients.

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Key result

CAC score >1,000 is linked to a ~12-fold higher all-cause mortality risk versus zero CAC.

RR 12.5
P<0.0001
n=25,253

Why the study?

Does coronary artery calcium (CAC) scoring improve the prediction of all-cause mortality beyond traditional risk factors in asymptomatic individuals?

Key Points

To develop risk-adjusted models incorporating CAC scores and risk factors for predicting all-cause mortality in asymptomatic patients.
Observational outcome study with a cohort of 25,253 asymptomatic individuals referred for CAC scanning.
Development of multivariable Cox proportional hazards models to predict mortality.
Incorporated traditional cardiovascular risk factors and CAC scores into risk-adjusted models.
44% had a CAC score of 0, with progressively higher risk associated with increasing scores.
Death rate was 2% (510 deaths) during a median follow-up of 6.8 years.
CAC scores significantly improved the prediction of mortality (concordance index increased from 0.61 to 0.81, p < 0.0001).

Study Design

Type

Observational (n=25,253)

Structured PICO

Does coronary artery calcium (CAC) scoring improve the prediction of all-cause mortality beyond traditional risk factors in asymptomatic individuals?

Population

25,253 consecutive, asymptomatic individuals referred for CAC scanning to assess cardiovascular risk, followed for a mean of 6.8 years.

Exposure

Coronary artery calcium (CAC) scoring measured with electron-beam tomography

Comparator

Traditional risk factors alone (or CAC score of 0)

Outcome

All-cause mortalityhard clinical

Main Result

Relative Risk: 12.5

p-value: p=<0.0001

Discussion

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Implication

Coronary artery calcium scoring provides independent, incremental prognostic information beyond traditional risk factors for predicting all-cause mortality in asymptomatic individuals.

Cite This Study

Budoff et al. (2007) conducted an observational in Cardiovascular risk in asymptomatic individuals (n=25,253). Coronary artery calcium (CAC) score vs. CAC score of 0 was evaluated on All-cause mortality (RR 12.5, p=<0.0001). Higher coronary artery calcium scores independently predicted all-cause mortality, with a 12.5-fold increased relative risk for scores >1,000 compared to a score of 0 (P<0.0001).

synapsesocial.com/papers/6a37ac80abc5e56f12b16ae2 https://doi.org/10.1016/j.jacc.2006.10.079

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Implication

Coronary artery calcium scoring provides independent, incremental prognostic information beyond traditional risk factors for predicting all-cause mortality in asymptomatic individuals.

Long-Term Prognosis Associated With Coronary Calcification

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Long-Term Prognosis Associated With Coronary Calcification

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider