Neutralizing the Adverse Prognosis of Coronary Artery Calcium

Bhatti, Salman K., DiNicolantonio, James J., Captain, Becky K., Lavie, Carl J., Tomek, Ales and O'Keefe, James H. (2013) Neutralizing the Adverse Prognosis of Coronary Artery Calcium. Mayo Clinic Proceedings, 88 8: 806-812. doi:10.1016/j.mayocp.2013.05.019

Author Bhatti, Salman K.
DiNicolantonio, James J.
Captain, Becky K.
Lavie, Carl J.
Tomek, Ales
O'Keefe, James H.
Title Neutralizing the Adverse Prognosis of Coronary Artery Calcium
Journal name Mayo Clinic Proceedings   Check publisher's open access policy
ISSN 0025-6196
Publication date 2013-08
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.mayocp.2013.05.019
Volume 88
Issue 8
Start page 806
End page 812
Total pages 7
Place of publication New York , U. S. A.
Publisher Elseiver
Collection year 2014
Language eng
Formatted abstract
To report and compare the outcomes and survival of patients with abnormal computed tomography–derived coronary artery calcium (CT-CAC) scores undergoing aggressive medical treatment at a cardiac prevention clinic.
Patients and Methods
We conducted a retrospective analysis of 849 patients with intermediate risk based on the Framingham risk score and an abnormal CT-CAC score who were aggressively treated in a preventive cardiology risk factor modification program from June 23, 2000, to September 1, 2012. The primary outcome was a composite end point of myocardial infarction, resuscitated cardiac arrest, revascularization, and cardiovascular death. The effect of the CT-CAC subgroup on major adverse coronary heart disease events (MACEs) was evaluated by calculating hazard ratios with Cox proportional hazards regression modeling. The Centers for Disease Control and Prevention Wonder database was used to identify age- and sex-matched controls from the general population of Kansas and Missouri.
The mean age of the study patients was 65.4 years (58.4% men [496]). The median follow-up was 58 months, and the mean CT-CAC score was 336 Agatston units. Thirty-four patients (4.0%) reached the primary end point, including 4 deaths. The adjusted 10-year mortality rates were similar in the study group and control group (9.3 vs 10.6; P=.80). After adjustment, a CT-CAC score greater than 400 Agatston units correlated with a higher risk of MACEs (hazard ratio, 3.55; P=.01).
These results suggest that intermediate-risk patients with abnormal CT-CAC scores when treated with intensive risk factor reduction have lower rates of MACEs than predicted by the Framingham risk score and the presence of coronary artery calcium.
Keyword Heart-disease
Asymptomatic adults
Cardiovascular risk
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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