Coronary artery calcium (CAC) > 0 was associated with an increased risk of MACE compared to CAC = 0 in asymptomatic (RR 4.05; 95% CI 2.91-5.63) and symptomatic (RR 6.06; 95% CI 4.23-8.68) patients.
Meta-Analysis (n=224,557)
Does a CAC score > 0 increase the risk of cardiovascular events in asymptomatic and symptomatic patients without established coronary artery disease?
The presence of any coronary artery calcium (CAC > 0) is strongly associated with an increased risk of MACE, all-cause mortality, and revascularization in both asymptomatic and symptomatic patients without established CAD.
Effect estimate: RR 4.05 (95% CI 2.91-5.63)
p-value: p=< 0.00001
BACKGROUND: Coronary artery calcium (CAC) is an indicator of atherosclerosis, and the CAC score is a useful noninvasive assessment of coronary artery disease. OBJECTIVE: To compare the risk of cardiovascular outcomes in patients with CAC > 0 versus CAC = 0 in asymptomatic and symptomatic population in patients without an established diagnosis of coronary artery disease. METHODS: A systematic search of electronic databases was conducted until January 2018 for any cohort study reporting cardiovascular events in patients with CAC > 0 compared with absence of CAC. RESULTS: Forty-five studies were included with 192 080 asymptomatic 32 477 symptomatic patients. At mean follow-up of 11 years, CAC > 0 was associated with an increased risk of major adverse cardiovascular and cerebrovascular events (MACE) compared to a CAC = 0 in asymptomatic arm [pooled risk ratio (RR) 4.05, 95% confidence interval (CI) 2.91-5.63, P 0 was also associated with increased risk of all-cause mortality in symptomatic population (pooled RR 7.94, 95% CI 2.61-24.17, P 0 was associated with higher all-cause mortality (pooled RR 3.23, 95% CI 2.12-4.93, P 0 was higher (pooled RR 15, 95% CI 6.66-33.80, P 0 was associated with more revascularization in asymptomatic population (pooled RR 5.34, 95% CI 2.06-13.85, P = 0.0006, I2 = 93). In subgroup analysis of asymptomatic population by gender, CAC > 0 was associated with higher MACE (RR 6.39, 95% CI 3.39-12.84, P 0 in both asymptomatic and symptomatic population without coronary artery disease.
Abuzaid et al. (Wed,) conducted a meta-analysis in Without established coronary artery disease (n=224,557). Coronary artery calcium (CAC) > 0 vs. CAC = 0 was evaluated on Major adverse cardiovascular and cerebrovascular events (MACE) in asymptomatic patients (RR 4.05, 95% CI 2.91-5.63, p=< 0.00001). Coronary artery calcium (CAC) > 0 was associated with an increased risk of MACE compared to CAC = 0 in asymptomatic (RR 4.05; 95% CI 2.91-5.63) and symptomatic (RR 6.06; 95% CI 4.23-8.68) patients.