Abstract 14392: Progression of Coronary Artery Calcium Score Predicts Higher Risk for Coronary Revascularization

Abstract

Introduction: The Coronary artery calcium (CAC) score is a powerful independent screening tool for coronary artery disease (CAD). Elevated CAC score has been significantly associated with increased rates of revascularization, however monitoring the progression of disease with a serial CAC score remains controversial. Hypothesis: The progression of the CAC score predicts the need for coronary revascularization. Methods: Data were analyzed retrospectively of patients who underwent two calcium scans between February 2008 and April 2021 as part of the Sanford Cardiovascular Prevention Program and were categorized into low (<100), moderate (100-399), or high ≥400) CAC groups. Progression of the CAC score between two scans was analyzed and the need for clinically indicated revascularization (PCI vs CABG) was evaluated by the chi-square test. Results: A total of 5809 subjects were screened for CAC score. 54.3% were females and the mean age was 55.6 ±10.35 years. Progression of CAC score (Low to moderate/high, moderate to high) and need for revascularization was statistically significant (P<0.001). In our study, patients who progressed from low to high and moderate to high CAC score category were found to have the highest rates of coronary revascularization, 11.92%, and 13.36 % respectively. Conclusions: In our study, patients who progressed to a high CAC score category were found to have a significantly increased need for revascularization. Repeating a CAC score in low to moderate risk patients may have clinical benefit and needs further investigation.