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Predictive Value of a Zero Coronary Artery Calcium Score in Major Adverse Cardiac Events in Old Age

AUTHORS

Anita Sadeghpour ORCID 1 , Mehrdad Azimi ORCID 1 , Hamid Reza Pouraliakbar ORCID 1 , Majid Kyavar ORCID 2 , Azin Alizadehasl ORCID 1 , Hossein Nazari Hayanou ORCID 3 , Reza Hajizadeh ORCID 4 , *

1 Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

2 Cardiovascular intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran

3 Echocardiography Lab, Department of Cardiology, Imam Reza International University, Mashhad, IR Iran

4 Department of Cardiology, Urmia University of Medical Sciences, Urmia, IR Iran

How to Cite: Sadeghpour A, Azimi M, Pouraliakbar H R, Kyavar M, Alizadehasl A, et al. Predictive Value of a Zero Coronary Artery Calcium Score in Major Adverse Cardiac Events in Old Age, Int Cardio Res J. 2019 ; 13(3):e88459.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 13 (3); e88459
Published Online: September 01, 2019
Article Type: Research Article
Received: September 03, 2019
Accepted: July 20, 2019

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Abstract

Background:

By estimating the total coronary plaque burden, the Coronary Artery Calcium (CAC) score determines the risk of Coronary Artery Disease (CAD). The presence of a zero CAC score may be highly predictive of very low risk patients for Major Cardiac Adverse Events (MACEs) due to its close relation with the severity of CAD.

Objective:

The present study aimed to evaluate the value of a zero CAC score for predicting MACEs in patients older than 60 years suspected of CAD.

Methods:

Between April 2011 and March 2012, 128 patients aged > 60 years with a zero CAC score on admission without a previous history of CAD were consecutively included in this study with a mean follow-up period of 45.7 months. The continuous variables were compared using t-test or Mann–Whitney U test and the categorical ones were compared using chi-square test. The statistical analyses were done using the SPSS statistical software, version 23.0.

Results: This study was conducted on 128 patients (35 males and 93 females). The incidence of MACEs was 2.3% in a mean follow-up period of 45.7 months and 0.6 per 100 patient-years. Additionally, the MACE-free survival rates were 99.1%, 99.1%, and 87.7% in one, three, and five years, respectively. The negative predictive value of a zero CAC score for predicting long-term MACEs was 100% in the patients older than 70 years and 96.8% in those aged between 60 and 70 years. No cardiac-related death was recorded within the follow-up period.

Conclusion: A zero CAC score had a high negative predictive value for predicting long-term MACEs in elderly patients with mild to moderate pretest probability of CAD, which reached 100% among the patients older than 70 years.

Keywords

Computed Tomography Angiography Aging Coronary Artery Disease Calcium Scoring

© 0, Shiraz University of Medical Sciences.

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