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Coronary Artery Calcium Score is a predictive tool for cardiovascular events in an asymptomatic population
Session:
Comunicações Orais - Sessão 29 - Score cálcio coronário
Speaker:
Francisco Homem de Gouveia e Sousa
Congress:
CPC 2023
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.2 Computed Tomography
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Francisco Sousa; Maria Isabel Mendonça; Margarida Temtem; Marco Serrão; Marina Santos; Débora Sá; Sofia Borges; Sónia Freitas; Eva Henriques; Mariana Rodrigues; António Drumond; Ana Célia Sousa; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong>Background: </strong> Recent research highlights the role of the coronary artery calcium score (CAC Score) in evaluating the severity of subclinical atherosclerosis in asymptomatic individuals without apparent cardiovascular disease (CVD). However, the influence of the CAC score on the prognosis of an asymptomatic population is not consensual. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong>Objective: </strong>Investigate the role of the CAC score as a predictive tool for the occurrence of cardiovascular events in an asymptomatic population without known CVD.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong>Methods:</strong> 1195 asymptomatic subjects (mean age 55.1±6.9 years, 73.8% male) selected from the prospective arm of the GENEMACOR study were followed up during 5.9±4.3 years. CAC score was performed by cardiac computed tomography and reported as Agatston units according to the Hoff Nomogram in low, moderate and high-risk categories. The bivariate analysis evaluated CV events in the three CAC score risk categories and in traditional risk factors (TRFs) individually. Multivariable Cox proportional hazard ratios (HR) with 95% confidence intervals (95% CI) assessed the variables independently associated with CV events occurrence. Kaplan-Meier estimated the survival in the CAC risk categories.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong>Results: </strong>None of the TRFs showed significant differences in the CV events percentages. As the CAC score category increases, the percentage of CV events rises<strong> </strong>(p<0.0001). After Cox regression analysis, the high CAC risk category remained a strong CV events predictor (HR=3.71; 95% CI 1.66-8.27; p=0.001), along with age and smoking (Table). At fifteen years of follow-up, 95.3%, 92.8%, and 84.3% survived in the low, moderate and high-risk categories, respectively (Long Rank test; p<0.0001). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong>Conclusion: </strong>The presence of coronary calcifications indicated a worse prognosis in our asymptomatic population. CAC score is an excellent predictive tool for the asymptomatic subjects with coronary atherosclerosis in progression and<span style="background-color:white"> could help initiate preventive therapy</span>. </span></span></p>
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