Prediction of serious cardiovascular events by determining coronary artery calcification measured by multi-slice computed tomography

Background: The efficacious prophylaxis of myocardial infarction requires an accurate identification of patients at risk. Conventional risk stratification is often insufficient for this. We therefore examined the predictive value of coronary calcifications for future cardiovascular events. Methods: We determined the extent of coronary calcification by multi-slice computed tomography in 924 patients (443 men, 481 women, aged 59.4 +/- 18.7 years) after coronary artery disease had been excluded by coronary angiography. To quantify coronary calcifications the volume score was calculated. After an observation period of 36 months was calculated the incidence of coronary revascularisation, myocardial infarction, and cardiac death. Results: During the observation period the event rates for coronary revascularization (5.4%/ year vs. 2.9%/ year), myocardial infarction (3.8%/ year vs. 1.8%/ year), and cardiac death (2.1 %/ year vs. 1.0%/ year) in patients with volume scores above the 75(th) percentile were significantly higher compared to the total study group. Correspondingly the scores in patients with revascularization (397 187), myocardial infarction (412 176), and cardiac death (422 184) were significantly higher compared to patients without cardiovascular events (218 167). In addition future cardiovascular events were excluded in patients without coronary calcifications. Conclusions: By determining coronary calcifications it was possible to identify patients at risk for myocardial infarction could be identified. Future cardiovascular events could not be observed in patients without coronary calcifications.