Association of Quantitative Coronary Artery Calcium Density Subtype Volumes With Major Adverse Cardiovascular Events
Authors' conclusion
Low-density HU volume was independently associated with an increased MACE risk and improved discrimination and reclassification over conventional approaches in a broad spectrum of individuals undergoing CAC scanning.
Study context
- Population
- Patients without prior CAD undergoing ECG-gated noncontrast CT for coronary artery calcification (CAC) scanning or as part of a cardiac imaging test
- Participants
- 2,028 / 2,782 / 2,366
- Exposure
- Low-, intermediate- and high-density CAC volumes vs MACE
- CACn = 2,028
- Single-photon emission computed tomography (SPECT)n = 2,782
- Positron emission tomography (PET)n = 2,366
- Outcome
- MACE:
- Mortality
- MI
- Unstable angina
- Late revascularization
- Follow-up
- Median 4.3 years (IQR 2.6-12.8)
Methodological detailsmultivariable analysis
- Multivariable analysis
Main finding
As reported in the abstract
MACE per log-transformed low-density CAC volume (130-199 Hounsfield unit (HU))
Hazard ratio (95% CI)P value
CAC
1.65(1.05–2.60)
P < 0.05SPECT
1.41(1.02–1.94)
P < 0.05PET
1.34(1.11–1.61)
P < 0.05Per log-transformed low-density CAC volume, as printed
- Intermediate- and high-density volumes not predictive of MACE
- P > 0.05
- MACE events overall
- 1,033 (14.4%)
Observational data: associations, not effects.
Further findings
| Outcome | CAC | SPECT | PET |
|---|---|---|---|
| Discrimination and reclassification with density CAC volumes | |||
| Global chi-square improvement | 9.1 | 16.1 | 16.6 |
| Net reclassification index | 47.3 (95% CI 33.2-61.4) | 49.6 (95% CI 36.8-62.4) | 15.4 (95% CI 5.9-24.9) |
- Discrimination and reclassification with density CAC volumes: P < 0.01
Original publication
Association of Quantitative Coronary Artery Calcium Density Subtype Volumes With Major Adverse Cardiovascular Events. JACC Adv. Published 23 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →