Related Experiment Video
Updated: Apr 7, 2026
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Long-Term Prognosis After Coronary Artery Calcification Testing in Asymptomatic Patients: A Cohort Study
Insights
Coronary artery calcification (CAC) scores accurately predict 15-year mortality in asymptomatic individuals. Higher CAC scores correlate with increased long-term mortality risk, aiding in risk stratification.
Area of Science:
- Cardiology
- Preventive Medicine
- Medical Imaging
Background:
- Coronary artery calcification (CAC) is linked to adverse clinical outcomes within 5 years.
- Predictive capabilities of CAC for long-term mortality in asymptomatic individuals require further elucidation.
Purpose of the Study:
- To assess the predictive accuracy of CAC scores for long-term all-cause mortality.
- To evaluate CAC as a biomarker for mortality risk in asymptomatic individuals.
Main Methods:
- Observational cohort study of 9715 asymptomatic patients.
- Coronary artery calcification scoring and binary risk factor data collected.
- Cox proportional hazards models and net reclassification improvement used to analyze 15-year all-cause mortality.
Main Results:
- CAC score strongly predicted 15-year all-cause mortality (P < 0.001).
- Mortality rates ranged from 3% to 28% for CAC scores of 0 to ≥1000.
- Relative hazard for mortality increased significantly with higher CAC scores.
Conclusions:
- CAC extent is a powerful predictor of 15-year mortality in asymptomatic patients.
- CAC serves as a valuable biomarker for estimating long-term patient outcomes.
- Study limitations include single-center data and limited risk factor information.
Background:
The extent of coronary artery calcification (CAC) and near-term adverse clinical outcomes are strongly related through 5 years of follow-up.
Objective:
To describe the ability of CAC scores to predict long-term mortality in persons without symptoms of coronary artery disease.
Design:
Observational cohort.
Setting:
Single-center, outpatient cardiology laboratory.
Patients:
9715 asymptomatic patients.
Measurements:
Coronary artery calcification scoring and binary risk factor data were collected. The primary end point was time to all-cause mortality (median follow-up, 14.6 years). Univariable and multivariable Cox proportional hazards models were used to compare survival distributions. The net reclassification improvement statistic was calculated.
Results:
In Cox models adjusted for risk factors for coronary artery disease, the CAC score was highly predictive of all-cause mortality (P < 0.001). Overall 15-year mortality rates ranged from 3% to 28% for CAC scores from 0 to 1000 or greater (P < 0.001). The relative hazard for all-cause mortality ranged from 1.68 for a CAC score of 1 to 10 (P < 0.001) to 6.26 for a score of 1000 or greater (P < 0.001). The categorical net reclassification improvement using cut points of less than 7.5% to 22.5% or greater was 0.21 (95% CI, 0.16 to 0.32).
Limitations:
Data collection was limited to a single center with generalizability limitations. Only binary risk factor data were available, and CAC was only measured once.
Conclusion:
The extent of CAC accurately predicts 15-year mortality in a large cohort of asymptomatic patients. Long-term estimates of mortality provide a unique opportunity to examine the value of novel biomarkers, such as CAC, in estimating important patient outcomes.
Primary Funding Source:
None.
More Related Videos
06:57Author Spotlight: Advancing Cardiovascular Imaging - Introducing the Spatially Weighted Calcium Score for Early Disease Detection
Published on: September 22, 2023
06:16Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Coronary Artery Disease V: Interprofessional Care
01:26Coronary Artery Disease IV: Preventive Measures
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...