Coronary artery calcium may be best indicator of CVD risk

(HealthDay)—The cardiovascular event rate is low for patients with no coronary artery calcium (CAC), which improves overall prediction among patients thought to be at risk of atherosclerotic cardiovascular disease (ASCVD), according to a letter to the editor published in the Aug. 1 issue of JACC: Cardiovascular Imaging.

Researchers looked at 6,814 people, aged 45 to 84, all free from ASCVD. Participants underwent two CAC scans and were followed for stroke, myocardial infarction, and cardiovascular death.

The team found that the overall event rate was 3.2 in 1,000 person-years. This included 2.9 in 1,000 person-years for those without CAC and 5.4 in 1,000 person-years for those with CAC scores of 1 to 10. Among subgroups of participants with other risk factors (such as advanced age, diabetes, smoking) and no CAC, none of the event rates exceeded the 7.5 percent 10-year risk threshold for cholesterol treatment. In multivariable models, only age, smoking, and hypertension significantly predicted ASCVD, with hypertension a more pronounced predictor in those with CAC scores of 1 to 10 compared to zero.

“With ASCVD rates much lower than 7.5 percent when CAC is absent, lifestyle modifications, smoking cessation, and hypertension control should be top priorities,” the authors write.

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