Association & reclassification between CT calcium scoring & clinical cardiovascular risk in asymptomatic patients.
| Abstract: |
- Introduction: Coronary artery calcium scoring (CACS) is an imaging tool that determines the calcified plaque burden in coronary arteries, which has been correlated with cardiovascular risk. Parameters such as abdominal circumference, diabetes mellitus, and age have been linked to calcified plaque progression. In Mexico, we currently lack information about the role of CACS in preventive care programmes, its function in reclassifying patients, and its correlation with other conditions linked to cardiovascular risk.
- Methods: Coronary calcified plaque burden was measured with ECG-gated chest CT scans using the Agatston method in patients of both sexes at our preventive care unit, retrospectively. Laboratory results and anthropometric measurements were obtained on the same day as the CT scans. The Framingham risk score and AHA/ACC ASCVD risk scores were calculated retrospectively.
- Results: We analysed a total of 520 asymptomatic patients (226 female; 294 male) who were examined at our preventive care centre between 2014 and 2018. In female patients, CACS has a positive correlation with abdominal circumference (p<0.001) and body mass index (BMI; p < 0.01). Considering both genders, CACS has a positive correlation with age (p<0.001), the AHA/ACC ASCVD risk algorithm (p < 0.001 in men; p<0.001 in women), and the Framingham risk score (p < 0.001 in men; p<0.001 in women). Male gender, older age, smoking habit, a previous diagnosis of diabetes, and abdominal circumference were found to be predictors of calcified plaque burden (p<0.001). CACS downwardly reclassified 44.9% of patients in intermediate cardiovascular risk categories by the AHA/ACC ASCVD risk algorithm and 43.9% by the Framingham risk score. Meanwhile, CACS upwardly reclassified 46.8% of the patients in intermediate risk categories by the AHA/ACC ASCVD risk algorithm and 56% by the Framingham risk score. Only 8.3% of patients in intermediate risk categories by the AHA/ACC ASCVD risk algorithm could not be reclassified.
- Conclusion: CACS reclassified a significant percentage of patients in lower and higher cardiovascular risk categories. Age, male gender, smoking habit, diabetes mellitus, and abdominal circumference were found to be independent predictors of calcified plaque burden. In both genders, age and both cardiovascular risk scores had a positive correlation with CACS, while BMI and abdominal circumference only had a positive correlation with CACS in the female group.
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- Data acquisition & analysis
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