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Value of Progression of Coronary Artery Calcification for Risk Prediction of Coronary and Cardiovascular Events

2017; Lippincott Williams & Wilkins; Volume: 137; Issue: 7 Linguagem: Inglês

10.1161/circulationaha.116.027034

1524-4539

Nils Lehmann, Raimund Erbel, Amir A. Mahabadi, Michael Rauwolf, Stefan Möhlenkamp, Susanne Moebus, Hagen Kälsch, Thomas Budde, Axel Schmermund, Andreas Stang, Dagmar Führer‐Sakel, Christian Weimar, Ulla Roggenbuck, Nico Dragano, Karl‐Heinz Jöckel, T. Meinertz, Christopher Bode, P.J. de Feyter, Bernhard Güntert, F Gutzwiller, Heinz Heinen, Olivia Hess, Ronald Klein, Hannelore Löwel, Maximilian Reiser, G. Schmidt, M. Schwaiger, C. Steinmüller, Töres Theorell, Stefan N. Willich, Christopher Bode, Klaus Berger, H. R. Figulla, C. W. Hamm, P. Hanrath, W. Köpcke, Bernd Ringelstein, Martin Dichgans, Andreas M. Zeiher,

Cardiac, Anesthesia and Surgical Outcomes

Computed tomography (CT) allows estimation of coronary artery calcium (CAC) progression. We evaluated several progression algorithms in our unselected, population-based cohort for risk prediction of coronary and cardiovascular events.In 3281 participants (45-74 years of age), free from cardiovascular disease until the second visit, risk factors, and CTs at baseline (b) and after a mean of 5.1 years (5y) were measured. Hard coronary and cardiovascular events, and total cardiovascular events including revascularization, as well, were recorded during a follow-up time of 7.8±2.2 years after the second CT. The added predictive value of 10 CAC progression algorithms on top of risk factors including baseline CAC was evaluated by using survival analysis, C-statistics, net reclassification improvement, and integrated discrimination index. A subgroup analysis of risk in CAC categories was performed.We observed 85 (2.6%) hard coronary, 161 (4.9%) hard cardiovascular, and 241 (7.3%) total cardiovascular events. Absolute CAC progression was higher with versus without subsequent coronary events (median, 115 [Q1-Q3, 23-360] versus 8 [0-83], P 5 years after the first scan may be of additional value, except when a double-zero CT scan is present or when the subjects are already at high risk.