Abstract 16044: Coronary Artery Calcium Score, a Superior Predictor of Cardiac Revascularization Risk Than Framingham

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 the Framingham Risk Score remains the most used method of predicting patients’ risk for future revascularization. Hypothesis: The CAC score is a superior predictor of adverse cardiac events than the traditionally accepted Framingham Risk Score. Methods: Data was analyzed retrospectively of patients who underwent calcium score scans between August 2011 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. The accuracy of revascularization prediction between subjects with CAC score and those without CAC score were evaluated by a ROC curve. Results: A total of 28,187 patients were screened for CAC score. 46% were females and the mean age was 61.4 ± 9.9 years. ROC predictive accuracy of patients with CAC scores (0.76) compared against those with no CAC score (0.71) was found to be statistically significant (Z = -6.27, P<0.01). Furthermore, total CAC was found to a significant predictor (b=.001, p<0.01) of revascularization above and beyond the additional risk factors with the pseudo R2 increasing from .08 for starting risk factors to .15 when total CAC was added for a pseudo R2 change of .07 Conclusions: In our study, CAC scoring was not only able to better predict the need for future revascularization compared to Framingham components but also able to improve the specificity of revascularization prediction when added to the Framingham components.