CAC Heart Scan Added to Risk Factors May Help Stratify CVD Death Risk

CAC Added to Risk Factors May Help Stratify CVD Death Risk

Marlene Busko

July 14, 2017

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WASHINGTON, DC — In a large registry study of asymptomatic patients who had a physician-requested coronary artery calcium (CAC) CT scan, a high CAC score predicted a higher risk of death during a mean follow-up of 12 years[1].

The mortality risk increased with increasing number of five traditional cardiovascular disease (CVD) risk factors.

“A higher CAC burden is strongly associated with risk of all-cause mortality, especially CVD/CHD mortality across an increasing burden of traditional risk factors,” Dr Gowtham R Grandhi (Baptist Health South Florida, Miami) reported in an oral session at the Society of Cardiovascular Computed Tomography (SCCT) 2017 Annual Scientific Meeting.

In an interview, Grandhi said that the study “has a long follow-up and a bigger study population than previous studies,” but he also conceded that “[CAC] does not replace the standard risk factors as a screening tool.” Still, “it can help better stratify the risk groups,” he said.

However, the added value of CAC screening “is always the problem, and that question is not finally resolved” with this study, session comoderator Dr Martin Hadamitzky (Technische Universität München, Germany) cautioned to | Medscape Cardiology.

“We know calcium scoring has an additional prognostic value, and this study suggests something like it’s better than traditional risk factors, [but] I’m not convinced,” he said. “Both are important.”

Compared with individuals with a CAC of 0, those with a CAC >400 had a 1.8-fold to 3.2-fold increased risk of all-cause death and a 3.1 to 5.1-fold increased risk of CVD death, depending how many traditional CVD risk factors they had.