CAC Score Predicts MACE in Patients With Stable Chest Pain

THURSDAY, March 14, 2024 (HealthDay News) — For people with stable chest pain referred for invasive coronary angiography (ICA), the risk for major adverse cardiovascular events (MACE) is low among those with a low coronary artery calcium (CAC) score, according to a study published online March 5 in Radiology.

Federico Biavati, M.D., from the Charité–Universitätsmedizin Berlin, and colleagues examined the prognostic value of CAC scoring for MACE in 1,749 study participants with stable chest pain initially referred for ICA. Participants were randomly assigned to ICA or coronary computed tomography (CT). CAC scores from noncontrast CT scans were classified as low, intermediate, and high (scores of 0, 1 to 399, and 400 or higher).

The researchers found an increase in the prevalence of obstructive coronary artery disease at CT angiography from 4.1 to 76.1 percent in the groups with CAC score 0 and CAC score 400 or higher. Across the same groups, there was an increase from 1.7 to 46.2 percent in revascularization rates. Lower MACE risk was seen in the groups with CAC scores 0 and 1 to 399 compared with the 400 or higher group (0.5 and 1.9 percent, respectively, versus 6.8 percent; hazard ratios, 0.08 and 0.27, respectively). There was no significant difference in MACE between the sexes.

“A coronary artery calcium score of 0 showed very low risk of major adverse cardiovascular events at follow-up, and increasing scores were associated with increasing rates of obstructive coronary artery disease, revascularization, and MACE,” the authors write.

Several authors disclosed ties to the pharmaceutical, medical device, and publishing industries.

Abstract/Full Text

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