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Prognostic impact of adding Coronary Calcium Score to European SCORE2 in an asymptomatic Portuguese population
Session:
Comunicações Orais (Sessão 5) - Risco CV, Prevenção e Reabilitação Cardíaca 1 - Foco nos Scores de Risco
Speaker:
Margarida Temtem
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Margarida Temtem; Maria Isabel Mendonça; Marco Serrão; Marina Santos; Débora sá; Carolina Soares; Ana Célia Sousa; Eva Henriques; Mariana Rodrigues; Sónia Freitas; Sofia Borges; Ilídio Ornelas; António Drumond; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif""><strong>Background:</strong> </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif""><span style="background-color:white"><span style="color:black">The new European </span></span><span style="color:black">SCORE2 estimates the combined risk of fatal and non-fatal cardiovascular (CV) events, in contrast with SCORE’s use for CV mortality only. </span><span style="color:black">Although controversial, several studies point out that Coronary Artery Calcification (CAC) scoring could improve CV risk stratification in primary prevention.</span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif""><strong>Purpose: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif"">Assess the impact of including CAC scoring to the new SCORE2 in MACE prediction and cardiovascular risk stratification. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif""><strong>Methods:</strong> </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif"">We calculate the new SCORE2 in a population-based cohort of 1,014 individuals without known CV disease and diabetes (mean age 58.6±8.5 years). <span style="color:black">Population was stratified into three SCORE2 risk categories (low, moderate and high)</span>. According to the Hoff’s nomogram, 3 categories were created for CAC score: low CAC (0≤CAC≤100 or P<50); moderate CAC (100≤CAC<400 or P50-75) and high or severe CAC (CAC≥400 or P>75). Kaplan-Meier survival curves were estimated and a multivariate regression analysed the MACE risk for both scores. C-statistic methodology evaluated the improved capacity of adding CAC to the SCORE2 model.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif""><strong>Results: </strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif"">Cox regression analysis showed that the highest categories of CAC and SCORE2 remained in the equation with an HR of 3.7 (p=0.008) and HR of 9.8 (p=0.005), respectively, when compared with the lowest categories. C-statistic demonstrated<span style="color:#010205"> that the predictive value for MACE was 0.668 for SCORE2 and 0.681 for CAC score. When CAC was added to the SCORE2 model, C-statistic increased to 0.787 (p=0.007)</span> <span style="background-color:white"><span style="color:black">showing a better discrimination capacity for MACE</span></span>.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif""><strong>Conclusions:</strong> </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,"sans-serif"">Our results highlight the importance of adding CAC score to SCORE2 in primary prevention to improve cardiovascular risk stratification and MACE prediction. Larger prospective multicenter cohorts with longer follow-up should reproduce and validate these findings.</span></span></p>
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