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. 2020 Oct;12(10):662-667.
doi: 10.14740/jocmr4335. Epub 2020 Sep 21.

A Coronary Artery Calcium Score of Zero in Patients Who Have Undergone Coronary Computed Tomography Angiography Is Associated With Freedom From Major Adverse Cardiovascular Events

Yuhei Shiga  1   2 , Joji Morii  1   2 , Yoshiaki Idemoto  1 , Kohei Tashiro  1 , Yuiko Yano  1 , Yuta Kato  1 , Takashi Kuwano  1 , Makoto Sugihara  1 , Shin-Ichiro Miura  1   3
Affiliations

A Coronary Artery Calcium Score of Zero in Patients Who Have Undergone Coronary Computed Tomography Angiography Is Associated With Freedom From Major Adverse Cardiovascular Events

Yuhei Shiga et al. J Clin Med Res. 2020 Oct.

Abstract

Background: The coronary artery calcification score (CACS) is a good marker of future cardiovascular risk. We determined the association between the CACS and the prognosis in patients who have undergone coronary computed tomography angiography (CCTA).

Methods: We performed a prospective cohort study and enrolled 502 consecutive patients who underwent CCTA for screening of coronary artery disease (CAD) at Fukuoka University Hospital (FU-CCTA Registry) and either were clinically suspected of having CAD or had at least one cardiovascular risk factor with a follow-up of up to 5 years. The patients were divided into CACS = 0 and CACS > 0 groups. Using CCTA, ≥ 50% coronary stenosis was diagnosed as CAD, and the number of significantly stenosed coronary vessels (VD), Gensini score and CACS were quantified. The primary endpoint was major adverse cardiovascular events (MACE: cardiovascular death, ischemic stroke, acute myocardial infarction and coronary revascularization).

Results: %CAD, the number of VD and the Gensini score in the CACS = 0 group were significantly lower than those in the CACS > 0 group. %MACE in the CACS = 0 group was also significantly lower than that in the CACS > 0 group. Kaplan-Meier curves indicated that the CACS = 0 group showed significantly greater freedom from MACE than the CACS > 0 group (P = 0.008). Finally, only CACS = 0 was independently associated with MACE (odd ratio: 0.41, 95% confidence interval: 0.17 - 0.97, P = 0.041).

Conclusions: A CACS of 0 in patients who underwent CCTA was associated with a good prognosis.

Keywords: Coronary artery calcification; Coronary artery disease; Coronary computed tomography angiography; Major adverse cardiovascular events.

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Conflict of interest statement

None to declare.

Figures

Figure 1
Figure 1
%CAD (a), number of VD (b), CACS (c) and Gensini score (d) in the CACS = 0 and CACS > 0 groups. CAD: coronary artery disease; number of VD: number of significantly stenosed coronary vessels; CACS: coronary artery calcium score.
Figure 2
Figure 2
(a) %MACE in the CACS = 0 and CACS > 0 groups. (b) Kaplan-Meier curves for freedom from MACE in the CACS = 0 and CACS > 0 groups. MACE: major adverse cardiovascular events; CACS: coronary artery calcium score.
See this image and copyright information in PMC

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