Prognostic Value of Coronary Artery Calcium in the Intermediate-Risk Population of Developing Coronary Artery Disease

Abstract

Background: The present study was designed to estimate the coronary artery calcium score (CACS) and its association with the incidence of major adverse cardiovascular events (MACE) in asymptomatic patients who are at risk of coronary artery disease (CAD). Objective: To estimate the CACS and its association with the incidence of MACE in asymptomatic patients. Methods: In this prospective cross-sectional observational study, 108 consecutive patients were enrolled. Demographic details and clinical data including lipid profile, systolic blood pressure, electrocardiography, 2D echocardiography, and routine blood investigations were reported. CACS was derived from computed tomography using a 256-slice scanner with a rotation time of 270 milliseconds. MACE was recorded at a one-year follow-up. Results: The mean age was 54.55 ± 7.7 years with male predominance (62%). CACS categories 0, 1-99, 10-399, 400-999, and more than 1000 constituted 43.5%, 28.7%, 18.52%, 8.33%, and 0.93% respectively. The correlation between the groups of positive and negative CACS and the presence or absence of standard risk factors was found to be statistically significant in diabetes mellitus (P=<0.001), hypertension (P=<0.001), and history of CAD in the family (P = 0.036). Although the association between smokers and calcium was statistically insignificant, it had clinical significance (P= 0.294). Out of 108 patients, MACE was observed in 16 (14.81%) patients with positive CACS at the 1-year follow-up. Conclusion:CACS measurement is often regarded as the primary non-invasive approach for risk stratification, MACE estimation, and promptly identifying high-risk asymptomatic individuals. Keywords: Coronary Artery Calcium Score; Cardiovascular Events; Coronary Calcification; Risk Stratificationa