Study: Coronary Artery Calcification Can Help Predict Mortality

New research finds that coronary artery calcification (CAC) scores can provide accurate predictions of 15-year all-cause mortality.
 
In a study of 9,715 adults based on a 15-year follow-up period, a team of investigators found individuals without CAC had a 15-year all-cause mortality rate of 3%, while overall mortality increased to 28% among those with CAC scores of 1,000 or higher.
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Prior to this report, many studies have discovered a great risk for worse clinical outcomes in patients with high CAC scores. But, as the authors note, many of these studies have been conducted over a relatively short period of time.
 
This data on long-term outcomes “can help clinicians to understand how well a given screening test—like CAC—can estimate long-term mortality,” says Leslee Shaw, PhD, a professor of medicine in the department of cardiology at Emory University, and co-author of the study.
 
As the majority of patients undergoing screening tests are middle-aged or elderly, longer follow-up can “more closely approximate life expectancy, more so than the usual 3 to 5-years of follow-up, which is more commonly used in publications,” says Shaw.
 
A low-risk finding has “a long warranty period. In this case, those with low-risk CAC scores had excellent survival over 15 years,” she says, noting that high-risk findings were associated with very high mortality rates.
 
For example, a CAC of 1,000 or higher had 15-year mortality rates of close to 30%, says Shaw, adding that previous reports on much short follow-up time periods have reported cardiac event rates in the range of 5% to 9%.
 
As such, “we believe that this information can prove very helpful in motivating patients with high-risk findings to be more adherent to preventive strategies, including lifestyle modifications of exercise and dietary changes.”
 
—Mark McGraw
 
Reference
 
Shaw L, Giambrone A, et al. Long-Term Prognosis After Coronary Artery Calcification Testing in Asymptomatic Patients: A Cohort Study. Ann Intern Med. 2015.