Abstract 12180: All-Cause Mortality by Age and Gender Based on Coronary Artery Calcium Scores at Ten Years Follow-Up
Objective: Although coronary artery calcium scores (CAC)has been established as a robust prognostic tool, the utility for long-term follow-up has not been examined. We investigated the prognostic utility of CAC by age and gender after a mean follow-up of 10 years.
Methods: We studied 13264 consecutive asymptomatic individuals without known coronary artery disease (mean 58±12 years, 67% men) undergoing CAC scanning by non-contrast cardiac computed tomography from December 1991 to December 2010. By Multivariable Cox proportional hazards models adjusting for risk factors and ethnicity, we examined all-cause mortality by age (≥65 or ≤65 years) and gender based on CAC score between 0, 1-99, 100-399 and ≥400.
Results: During a mean follow-up of 10.1±3.4 years, 550 individuals (4.2%) died. In comparison to women at age ≤65 years having a CCS zero, the mortality rates were significantly higher in both women and men with increasing CAC at age ≤65 or ≥65 years. Furthermore even patients with a CAC score of zero and age ≥65, as compared to women with a CAC score of zero and age ≤65, had 3.8 and 5.2 fold increase in mortality rates for both women and men (Table). Ten-year survival of women aged ≤65, men aged ≤65, women aged ≥65 and men aged ≥65 having CCS of zero were 98.4%, 97.7%, 92.7% and 90.5%, respectively.
Conclusion: During the mean follow-up of 10 years, CAC predicts future mortality risk among both women and men at ≤65 or ≥65 years. The prognostic utility of a CAC score of zero is excellent for younger patients. Older patients may need more frequent serial assessments of CAC within 10 years, as events in those with CAC zero start to rise by year10.
- © 2013 by American Heart Association, Inc.