Coronary artery calcium progression did not significantly improve the prediction of total cardiovascular events when the most recent 5-year CAC value and risk factors were already included in the model.
Cohort (n=3,281)
Yes
Does CAC progression improve risk prediction for coronary and cardiovascular events beyond baseline or most recent CAC and risk factors in a population-based cohort?
CAC progression adds little to cardiovascular risk prediction beyond the most recent CAC score and current risk factors, suggesting that the latest CAC value is the most important metric.
Effect estimate: HR 1.04 (95% CI 0.95-1.13)
p-value: p=0.445
Background: Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular events. Methods: In 3281 participants (45–74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed. Results: We observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 Q1–Q3, 23–360 versus 8 0–83, P 5 years after the first scan may be of additional value, except when a double-zero CT scan is present or when the subjects are already at high risk.
Lehmann et al. (Wed,) conducted a cohort in Cardiovascular risk (n=3,281). Coronary artery calcium (CAC) progression assessment vs. Most recent CAC value (CAC5y) and risk factor assessment was evaluated on Total cardiovascular events (Absolute CAC progression added to model with CAC5y) (HR 1.04, 95% CI 0.95-1.13, p=0.445). Coronary artery calcium progression did not significantly improve the prediction of total cardiovascular events when the most recent 5-year CAC value and risk factors were already included in the model.
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