Abstract 15849: 15-year Prognostic Value of Coronary Artery Calcium Scoring for Predicting All-cause Mortality Beyond Traditional Risk Scoring Algorithms in Patients Without Conventional Cardiac Risk Factors
Introduction: Current guidelines for cardiovascular disease (CVD) risk assessment underline that coronary artery calcium (CAC) scoring should only be considered among patients at intermediate risk. Yet, traditional CVD risk assessment tools are often misclassify risk, especially in low risk population.
Hypothesis: We explored the prognostic value of CAC for detecting mortality events over and above traditional risk prediction tools, in a group of low CVD risk patients - without the presence of conventional CVD risk factors.
Methods: A total 1,386 asymptomatic individuals (mean age: 52.3±9.9 years, 59% male) who underwent CAC scanning and who were free of known CVD risk factors (i.e., hypertension, diabetes, dyslipidemia, and current smoking) comprised the study sample. The Framingham 10-year risk score (FRS) and 10-year atherosclerotic cardiovascular diseases (ASCVD) risk score were assessed as conventional risk prediction tools, and categorized as very low (<5%), low (5-10%), and intermediate or high (>10%) CVD risk groups. Subsequently, CAC scores were categorized as 0, 1-100, and >100 for assessing the risk of death from all-causes beyond the traditional risk algorithms.
Results: During a median 15 (IQR 14-16) years follow-up, 72 (5.2%) deaths occurred. When stratifying CVD risk groups based on both risk prediction tools, persons with a CAC >100 displayed a higher incidence of mortality as compared with those whose CAC = 0, or CAC 1-100. The addition of CAC to the FRS and ASCVD risk scores significantly improved discrimination for all-cause mortality (e.g., AUC for FRS: 0.63 vs. FRS + CAC: 0.72, Pdifference =0.002; and AUC for ASCVD score: 0.59 vs. ASCVD + CAC: 0.71, Pdifference <0.001).
Conclusions: CAC scoring provided incremental value for long-term prediction of all-cause mortality beyond traditional risk prediction tools, in persons without conventional risk factors.
Author Disclosures: D. Han: None. B. Ó Hartaigh: None. J. Lee: None. A. Rizvi: None. L. Baskaran: None. J. Schulman-Marcus: None. F.Y. Lin: None. T. Callister: None. J.K. Min: Research Grant; Modest; GE Healthcare, NIH/NHLBI R01 HL118019, NIH/NHLBI R01 HL115150, NIH/NHLBI R01 HL111141, NIH/NHLBI U01 HL105907, QNRF NPR-370-3-089. Ownership Interest; Modest; Autoplaq, MDDX. Consultant/Advisory Board; Modest; HeartFlow, Arineta. H. Chang: None.
- © 2016 by American Heart Association, Inc.