Abstract 15042: BioImage Study: Combined Use of Novel Biomarker Panel (CardioSCORE) and Computed Tomography Coronary Calcium Scores in Predicting Major Adverse Cardiovascular Events

Abstract

Background: Coronary artery calcification (CAC) measurement has proven consistent for prognostication for adverse cardiac events. In this study we aim to interaction of multi-marker panel of 7 proteins (CardioSCORE) with CAC in predicting major adverse cardiac events (MACE). The CardioSCORE panel had been discovered and developed from myocardial infarction case-cohort studies as part of the Copenhagen Heart Studies.

Methods: The study population is derived from the prospective BioImage Study designed to evaluate associations among imaging and circulating biomarkers and their ability to predict near-term atherothrombotic events in asymptomatic at-risk subjects aged 55 years and above. The CardioSCOREis presented as a single numerical score based on the levels of Apolipoprotein A1, Apolipoprotein B, beta-2 microglobulin, carcinoembryonic antigen, high sensitivity C-reactive protein, lipoprotein(a), and transferrin.

Results: The study population consisted of 5,763 individuals (69±6 years, 44% males). The median (IQR) CardioSCORE was 4.6 (3.7-5.6). In a median follow-up of 2.4 years, 268 (4.8%) MACE was noted. In Framingham risk score (FRS), race, CAC scores and CardioSCORE adjusted Cox regression analyses, the hazard ratio for MACE ranged from 1.40 (0.93-2.11), 1.72 (1.15-2.56), to 2.16 (1.46-3.20) folds with increasing quartiles (2-4 vs. 1^st quartile). In comparison, the respective hazard ratios with increasing CAC scores (1-100, 101-400, >400 vs CAC=0) were 1.33 (0.89-1.98), 1.83 (1.23-2.73) & 3.17 (1.23-2.73). Increasing CardioSCORE was associated with increased risk of MACE at all levels of CAC scores, with highest risk observed in those with CAC>400 and CardioSCORE in the 4^th quartile (figure).

Conclusion: These data demonstrate that a composite aggregate derived from a 7 biomarker and CAC provide complementary information in the assessment of near-term risk of disease over and above that conveyed by the FRS.