Predictive values of coronary artery calcium and arterial stiffness for long-term cardiovascular events in patients with stable coronary artery disease
Issued Date
2023-02-01
Resource Type
ISSN
01609289
eISSN
19328737
Scopus ID
2-s2.0-85143236613
Pubmed ID
36448219
Journal Title
Clinical Cardiology
Volume
46
Issue
2
Start Page
171
End Page
183
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Cardiology Vol.46 No.2 (2023) , 171-183
Suggested Citation
Limpijankit T., Jongjirasiri S., Meemook K., Unwanatham N., Thakkinstian A., Laothamatas J. Predictive values of coronary artery calcium and arterial stiffness for long-term cardiovascular events in patients with stable coronary artery disease. Clinical Cardiology Vol.46 No.2 (2023) , 171-183. 183. doi:10.1002/clc.23955 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82440
Title
Predictive values of coronary artery calcium and arterial stiffness for long-term cardiovascular events in patients with stable coronary artery disease
Other Contributor(s)
Abstract
Background: Subclinical atherosclerosis detected by increased coronary artery calcium (CAC) or arterial stiffness as reflected by cardio-ankle vascular index (CAVI) has been associated with major adverse cardiovascular events (MACEs). However, comparative data from these two assessments in the same population are still limited. Methods: From 2005 to 2013, patients with stable coronary artery disease (CAD), both asymptomatic and symptomatic who underwent both coronary computed tomography and CAVI were enrolled and followed for occurrence of MACEs (cardiovascular [CV] death, nonfatal myocardial infarction [MI], and nonfatal stroke) until December 2019. A cause-specific hazard model was applied to assess the associations of CAC score, and CAVI with long-term MACEs. Results: A total of 8687 patients participated. Of them, CAC scores were 0, 1–99, 100–399, and ≥400 in 49.7%, 31.9%, 12.3%, and 6.1%, respectively. Arterial stiffness (CAVI ≥ 9.0) was associated with the magnitude of CAC in 23.8%, 36.3%, 44.5%, and 56.2%, respectively. During an average of 9.9 ± 2.4 years follow-up, MACEs occurred in 8.0% (95% CI: 7.4%, 8.6%) of subjects. After adjusting for covariables, CAC scores of 100–399 and ≥400, and CAVIs of ≥9.0 were found to independently predict the occurrence of MACEs with the hazard ratios (95% CI) of 1.70 (1.13, 1.98), 1.87 (1.33, 2.63), and 1.27 (1.06, 1.52), respectively. Other risk predictors were hypertension, diabetes mellitus (DM), chronic kidney disease (CKD), aspirin, and statin therapy. Conclusions: A CAC score ≥100 or a CAVI ≥ 9.0 predicts the long-term occurrence of MACEs in both asymptomatic and symptomatic patients with stable CAD. These two noninvasive tests can be used as screening tools to guide treatment for the prevention of future CV events.
