P1773Impact of coronary artery calcium score on cardiovascular risk stratification: a multicenter analysis

Abstract

Introduction: Recently, a 10-year cardiovascular risk score based on the Multi- Ethnic Study of Atherosclerosis (MESA) was proposed, allowing the calculation of cardiovascular risk based on several clinical variables, to which coronary artery calcium (CAC) score can be added. The purpose of this study was to assess the impact of adding CAC information to the cardiovascular risk stratification of patients undergoing coronary CT angiography (CCTA) for suspected obstructive coronary artery disease (CAD). Method(s): Patients undergoing CCTA for suspected CAD in two centers were eligible for this retrospective analysis. We excluded patients with known cardiovascular disease (history of acute coronary syndrome, revascularization, stroke or obstructive peripheral arterial disease), those in whom CCTA showed obstructive plaques (coronary stenosis>=50%), and patients with missing data on one or more variables of the score. The MESA score was calculated for each patient with and without the CAC data. Patients were categorized in low (<5.0%), intermediate (5.0%-7.5%) or high risk (>7.5%), according to published guidelines. Result(s): A total of 483 patients (256 women, mean age 60+/-9 years) met the inclusion criteria. MESA score and CAC score were 3.9 (IQR 2.2-8.0) and 0.7 (IQR 0.0-46.0), respectively. The MESA score calculated without the CAC data ranked 181 (37.5%), 113 (23.4%) and 189 (39.1%) patients into the low, intermediate and high-risk categories, respectively. The recalculation of the MESA score with CAC data resulted in the reclassification of 184 (38.1%) patients. In the intermediate risk group, 82.3% (n=93) of the patients were reclassified, mostly to the low risk group (63.7%, n=72) - Figure 1. Conclusion(s): A significant proportion of patients undergoing CCTA for suspected CAD are reclassified with the inclusion of CAC score in cardiovascular risk assessment. These results support systematically performing CAC score in patients undergoing CCTA. (Figure Presented) .