Usefulness of regional distribution of coronary artery calcium to improve the prediction of all-cause mortality

The American Journal of Cardiology
Rajesh Tota-MaharajMichael J Blaha

Abstract

Although the traditional Agatston coronary artery calcium (CAC) score is a powerful predictor of mortality, it is unknown if the regional distribution of CAC further improves cardiovascular risk prediction. We retrospectively studied 23,058 patients referred for Agatston CAC scoring, of whom 61% had CAC (n=14,084). CAC distribution was defined as the number of vessels with CAC (0 to 4, including left main). For multivessel CAC, "diffuse" CAC was defined by decreasing percentage of CAC in the single most affected vessel and by ≤75% total Agatston CAC score in the most calcified vessel. All-cause mortality was ascertained through the social security death index. The mean age was 55±11 years, with 69% men. There were 584 deaths (2.5%) over 6.6±1.7 years. Considerable heterogeneity existed between the Agatston CAC score group and the number of vessels with CAC. In each CAC group, increasing number of vessels with CAC was associated with an increased mortality rate. After adjusting for age, gender, Agatston CAC score, and cardiovascular risk factors, increasing number of vessels with CAC was associated with higher mortality risk compared with single-vessel CAC (2-vessel: HR 1.61 [95% CI 1.14 to 2.25], 3-vessel: 1.99 [1.44 to 2.77], ...Continue Reading

References

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Citations

Apr 5, 2016·The Journal of Physiology·Jessica L RuizJoshua D Hutcheson
Nov 14, 2018·Journal of Computer Assisted Tomography·Nagina MalguriaElliot K Fishman
Apr 4, 2020·American Journal of Epidemiology·Jonathan T UnkartMichael H Criqui
Nov 23, 2019·Current Atherosclerosis Reports·Hong Loan NguyenTina Shah
Oct 6, 2020·Journal of Internal Medicine·B Y C CheongR Muthupillai
Mar 30, 2021·Radiology. Cardiothoracic Imaging·Olufunmilayo H ObisesanMichael J Blaha
Jul 30, 2021·European Heart Journal Cardiovascular Imaging·David J WinkelSaikiran Rapaka

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