Coronary Artery Calcium Density and Risk of Cardiovascular Events A Systematic Review and Meta-Analysis

被引：3

作者：

Yong, Yuanqi ^{[1
]}

Giovannucci, Julian ^{[1
]}

Pang, Sow Neng ^{[1
]}

Hong, Wei ^{[2
]}

Han, Donghee ^{[3
,4
]}

Berman, Daniel S. ^{[3
,4
]}

Dey, Damini ^{[5
]}

Nicholls, Stephen J. ^{[6
,7
]}

Nerlekar, Nitesh ^{[6
,7
]}

Lin, Andrew ^{[6
,7
]}

机构：

[1] Monash Hlth, Clayton, Vic, Australia

[2] Walter & Eliza Hall Inst Med Res, Parkville, Vic, Australia

[3] Cedars Sinai Med Ctr, Dept Imaging & Med, Los Angeles, CA USA

[4] Cedars Sinai Med Ctr, Smidt Heart Inst, Los Angeles, CA USA

[5] Cedars Sinai Med Ctr, Biomed Imaging Res Inst, Los Angeles, CA USA

[6] Monash Univ, Monash Hlth Heart Inst, Victorian Heart Hosp, Clayton, Vic, Australia

[7] Monash Univ, Victorian Heart Hosp, Monash Hlth Heart, Clayton, Vic, Australia

来源：

JACC-CARDIOVASCULAR IMAGING | 2025年 / 18卷 / 03期

基金：

芬兰科学院;

关键词：

atherosclerosis; cardiac computed tomography; cardiovascular risk; coronary artery calcium density; coronary artery calcium score; PLAQUE; CALCIFICATION; PROGRESSION; SCORE;

D O I：

10.1016/j.jcmg.2024.07.024

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND There is increasing evidence that coronary artery calcium (CAC) density is inversely associated with plaque vulnerability and atherosclerotic cardiovascular disease risk. OBJECTIVES A systematic review and meta-analysis were performed to examine the predictive value of CAC density for future cardiovascular events in asymptomatic individuals undergoing noncontrast CAC scoring computed tomography. METHODS Electronic databases were searched for studies reporting CAC density and subsequent cardiovascular disease (CVD) or coronary heart disease (CHD) events. Two independent reviewers performed data extraction. Random-effects models were used to estimate pooled HRs and 95% CIs. Subgroup analyses were performed with studies stratified by CVD vs CHD events and by statin use. RESULTS Of 5,029 citations, 5 studies with 6 cohorts met inclusion criteria. In total, 1,309 (6.1%) cardiovascular events occurred in 21,346 participants with median follow-up ranging from 5.2 to 16.7 years. Higher CAC density was inversely associated with risk of cardiovascular events following adjustment for clinical risk factors and CAC volume (HR: 0.80 per SD of density [95% CI: 0.72-0.89]; P < 0.01; I2 = 0%). There was no significant difference in the pooled HRs for CVD vs CHD events (HR: 0.80 per SD [95% CI: 0.71-0.90] vs 0.74 per SD [95% CI: 0.59-0.94] respectively; P = 0.59). The protective association between CAC density and event risk persisted among statin-naive patients (HR: 0.79 per SD [95% CI: 0.70-0.89]; P < 0.01) but not statin-treated patients (HR: 0.97 per SD [95% CI: 0.77-1.22]; P = 0.78); the test for interaction indicated no significant between-group differences (P = 0.12). CONCLUSIONS Higher CAC density is associated with a lower risk of cardiovascular events when adjusted for risk factors and CAC volume. Future work may expand the contribution of CAC density in CAC scoring, and enhance its role in CVD risk assessment, treatment, and prevention.

引用

页码：294 / 304

页数：11

共 32 条

[1] QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].

AGATSTON, AS ;

JANOWITZ, WR ;

HILDNER, FJ ;

ZUSMER, NR ;

VIAMONTE, M ;

DETRANO, R .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 15 (04) :827-832

[2]

Arnett DK, 2019, CIRCULATION, V140, pE563, DOI [10.1016/j.jacc.2019.03.010, 10.1161/CIR.0000000000000677, 10.1161/CIR.0000000000000678, 10.1016/j.jacc.2019.03.009]

[3] Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials [J].