The value of coronary calcium score in predicting clinical outcomes in patients with chronic coronary syndrome

Abstract

Background Coronary artery atherosclerosis and calcification are the precursors to the development of coronary artery disease and its complications. Coronary artery calcium scoring (CACS) is useful as a risk-stratification tool in coronary artery disease. Objective The current study was designed to identify the relationship between CACS and major adverse cardiovascular outcomes in patients with stable coronary artery disease. Methods The study was conducted on 435 patients with stable ischemic heart disease. The patients were classified into two groups according to their CACS; group I (n: 220 patients) whose calcium score was mild to moderate < 400, and group II (n: 215 patients) whose calcium score was high ≥ 400. All patients were closely monitored for two years to assess major adverse cardiovascular events (MACE). Results After 2 years of follow-up, MACE drastically increased in group II in the form of unstable angina, myocardial infarction, demand for PCI, and heart failure. Multivariate regression analysis showed that age ≥ 55 years, Framingham risk score > 10, CACS ≥ 400, body mass index ≥ 30 kg/m² and the proximal lesions of the vessels were the independent risk factors for major cardiac events. Conclusion The coronary calcium score is a distinct feature of coronary atherosclerosis, and a score of 400 or higher is a reliable noninvasive predictor of the progression of coronary artery diseases and their consequences, including MACE.