Abstract 12435: Coronary Artery Calcium Score of Zero Predicts Lower All-Cause Mortality Over a Long-Term Follow-Up
Background: Coronary artery calcium (CAC) scoring has been shown in numerous studies to correlate well with adverse cardiovascular outcomes. In particular, a CAC score of zero has been linked with excellent survival. However, the majority of studies report only short-term follow-up results, and there is little data available on the long-term significance of a zero CAC score.
Methods: A total of 9,074 (53±10 years, 60% male) consecutive asymptomatic individuals, free of known coronary heart disease (CHD), underwent CAC Agatston scoring for cardiovascular risk assessment. CHD risk factors were prospectively obtained by patient interview. Unadjusted and risk-factor adjusted Cox proportional hazard modeling was used to estimate time to all-cause mortality (median follow-up=14.7 years) by CAC subsets and was compared to general population mortality estimates.
Results: Of all patients enrolled, 4,537 (50.0%) had a CAC score of zero. Annual all-cause mortality, based on adjusted Cox hazard modeling, was significantly lower in both men and women with a CAC score of zero than would be predicted for the general population (see Figure). The median reduction in projected annual mortality was 68.4% for men and 51.2% for women, with the degree of mortality reduction increasing with age. Compared to a CAC score of zero, even a low-risk CAC score of 1-10 was associated with an increased risk of all-cause mortality (HR = 4.19, 1.97, 2.44*, 1.82*, and 1.70* at 1, 3, 5, 10, and 15 years of follow-up, respectively), though importantly this effect did not reach statistical significance until 5 years of follow-up.
Conclusion: A CAC score of zero is associated with a markedly decreased risk of all-cause mortality compared to the general population, and its significance increases with both age and length of follow-up.
Author Disclosures: J.T. Knapper: None. T. Lebeis: None. G. Southmayd: None. P. Sandesara: None. M.J. Blaha: None. D. Berman: None. A. Quyyumi: None. M.J. Budoff: None. J.K. Min: None. V. Valenti: None. T.Q. Callister: None. A.E. Giambrone: None. L.J. Shaw: None.
- © 2014 by American Heart Association, Inc.