Long-Term Prognosis After Coronary Artery Calcium Scoring Among Low-Intermediate Risk Women and Men

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Imaging

Background:

• Traditional cardiovascular risk factors often underestimate risk in women.
• Asymptomatic individuals with low-intermediate risk require better prognostic tools.

Purpose of the Study:

• To evaluate the long-term prognosis of asymptomatic women and men with low-intermediate cardiovascular risk using coronary artery calcium (CAC) scoring.
• To compare the effectiveness of CAC scoring versus traditional risk factors in identifying at-risk women.

Main Methods:

• 2363 asymptomatic individuals with low-intermediate Framingham risk scores underwent CAC scanning.
• Follow-up median of 14.6 years with all-cause mortality analysis using Cox proportional hazards models.
• Receiver operating characteristics curve analysis to assess diagnostic performance.

Main Results:

• Older women (55.6 years) had higher CAC prevalence and extent than men (46.7 years).
• Women with CAC scores >10 exhibited increased mortality risk compared to men.
• 15-year mortality varied significantly with CAC scores in both sexes, ranging from 5.0% (women, CAC=0) to 23.5% (women, CAC≥400).

Conclusions:

• CAC scoring effectively identifies high-risk women with a low-intermediate traditional risk factor burden.
• CAC utilization in women can enhance risk detection algorithms beyond traditional factors.
• Further validation in external cohorts is recommended to support CAC use in women's cardiovascular risk assessment.