Key result
A Coronary Artery Calcium Score strongly predicted subsequent coronary interventions over 10 years, with an average AUC of 0.838 (95% CI 0.774-0.889) for PCI and CABG.
Why the study?
There is no consensus as to whether coronary artery calcium score results affect the selected therapeutic approach for coronary artery disease.
Does the Coronary Artery Calcium Score predict subsequent coronary interventions in asymptomatic patients over 10 years?
Cohort (n=174)
No
Does the Coronary Artery Calcium Score predict subsequent coronary interventions in asymptomatic patients over 10 years?
Effect estimate: AUC 0.838 (95% CI 0.774-0.889)
Absolute Event Rate: 32.6% vs 5.8%
p-value: p=0.0000
A higher Coronary Artery Calcium Score (≥400 AU) strongly predicts the need for subsequent percutaneous or surgical coronary revascularization over a 10-year follow-up in asymptomatic patients.
There is no consensus as to whether the Coronary Artery Calcium Score (CACS) results can affect the therapeutic approach that is selected for coronary artery disease. The aim of this study was to follow patients’ management over a period of ten years after application of the CACS. Methods: The research was conducted as a prospective, single-center, long-distance study. In 174 asymptomatic patients (78M; aged 58.9 ± 7.86), a CACS examination using 64-slice computed tomography was performed between 2008 and 2009. The patients were divided into three subgroups according to the CACS results using Agatston Units (AU)—G1: CACS = 0 AU (52 pts); G2: CACS = 1–399 AU (64 pts) and G3: CACS ≥ 400 AU (58 pts). During the ten years of follow-up, the classical cardiovascular risk factors, drugs, diseases, and information about the therapeutic approach that was used (PCI—Percutaneous Coronary Intervention; CABG—Coronary Artery Bypass Graft) were also analyzed. Results: The average time until a percutaneous intervention (PCI) was 825.2 ± 1111.7 and for CABG, it was 529.0 ± 833.6. PCI was performed in 5.8% (G1), 4.7% (G2) and 32.6% (G3) of the cases, respectively; p = 0.0000. CABG was performed in 0% (G1), 1.6% (G2) and 18.9% (G3) of the cases, respectively; 0.0035 Yates. The area under the curve in PCI was 0.783 (95% CI: 0.714–0.841); in CABG, it was 0.825 (95% CI: 0.760–0.878) and the average for both groups was 0.838 (95% CI: 0.774–0.889). Conclusions: The coronary artery calcium score can potentially help to predict the best therapeutic approach for coronary artery disease in a ten-year perspective.
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Młynarska et al. (2019) conducted a cohort in Coronary artery disease (n=174). Coronary Artery Calcium Score (CACS) vs. CACS = 0 AU was evaluated on Subsequent coronary interventions (PCI or CABG) (AUC 0.838, 95% CI 0.774-0.889, p=0.0000). A Coronary Artery Calcium Score strongly predicted subsequent coronary interventions over 10 years, with an average AUC of 0.838 (95% CI 0.774-0.889) for PCI and CABG.
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