AHA: Coronary Artery Calcium Score Can Predict Total Mortality

MONDAY, Nov. 10, 2025 (HealthDay News) — A coronary artery calcium (CAC) score of 0 has excellent prognosis for total mortality (TM), according to a study presented at the American Heart Association Scientific Sessions 2025, held from Nov. 7 to 10 in New Orleans.

Jeffrey L. Anderson, M.D., from Intermountain Health in Salt Lake City, and colleagues examined whether CAC can predict the risk for TM and whether cause-specific and noncoronary mortality distributions are affected by CAC. Patients at primary coronary risk who underwent positron emission tomography/computed tomography (CT) stress testing and had a five-year follow-up were identified from the Intermountain Health electronic medical records database.

A total of 40,018 patients were identified: 19.9 percent had CAC of 0 by CT and 32,051 had CAC >0. The researchers identified 238 and 2,834 deaths in CAC 0 and CAC >0 cohorts, respectively (2.99 versus 8.84 percent; relative risk, 0.34). CAC >0 remained a highly significant risk factor in age- and sex-adjusted logistic regression (odds ratio, 2.04). CAC of 0 predicted a very low proportion of coronary artery disease (CAD)-related and total cardiovascular deaths. In patients with CAC >0, most of the increased rate of TM was estimated to be noncardiovascular.

“The implications of a zero CAC score may go beyond simply marking a low risk of CAD-related events to also being a marker of general vascular health and improved overall survival,” the authors write.

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