The Impact of the Coronary Artery Calcium Score on the Clinical Outcomes in Patients with Acute Myocardial Infarction

: It is essential to identify the risk factors for poor clinical outcomes in patients with acute myocardial infarction (AMI). The coronary artery calcium score (CACS) is gathering attention as a predictor for future cardiovascular events. This study aimed to (1) measure CACSs in patients with AMI by...

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Veröffentlicht in:Journal of clinical medicine 2024-11, Vol.13 (23), p.7136
Hauptverfasser: Sato, Hisashi, Sakakura, Kenichi, Jinnouchi, Hiroyuki, Taniguchi, Yousuke, Yamamoto, Kei, Tsukui, Takunori, Hatori, Masashi, Kasahara, Taku, Watanabe, Yusuke, Ishibashi, Shun, Seguchi, Masaru, Fujita, Hideo
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Sprache:eng
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Zusammenfassung:: It is essential to identify the risk factors for poor clinical outcomes in patients with acute myocardial infarction (AMI). The coronary artery calcium score (CACS) is gathering attention as a predictor for future cardiovascular events. This study aimed to (1) measure CACSs in patients with AMI by non-ECG-gated computed tomography (CT), (2) compare clinical outcomes between patients with a high CACS and a low-intermediate CACS and (3) to elucidate the association between high CACS and clinical outcomes. : We defined the high CACS group as the highest quantile of CACS (Q4) and defined the low-intermediate CACS group as the other quantiles of CACS (Q1-Q3). The primary endpoint was major adverse cardiovascular events (MACE), which were defined as the composite of all-cause death, re-admission for heart failure, non-fatal MI and target vessel revascularization. We included 548 patients with AMI who underwent non-ECG-gated CT and divided them into the high CACS group (CACS ≥ 5346.5, = 137) and the low-intermediate CACS group (CACS ≤ 5329.3, = 411). : During the median follow-up duration of 535 days, 150 MACE were observed. The Kaplan-Meier curves showed that MACE occurred more frequently in the high CACS group than in the low-intermediate CACS group ( < 0.001). Multivariable Cox hazard analysis revealed that a high CACS was significantly associated with MACE (hazard ratio 1.597, 95% confidence interval 1.081-2.358, = 0.019) after controlling for multiple confounding factors. : Clinical outcomes were worse in AMI patients with a high CACS than in those with a low-intermediate CACS. A high CACS was significantly associated with MACE in multivariate analysis.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13237136