Prevention & lipidsMeta-analysis
Coronary Artery Calcium Density and Risk of Cardiovascular Events
- Systematic review and meta-analysis
- random-effects
Authors' conclusion
Higher CAC density is associated with a lower risk of cardiovascular events when adjusted for risk factors and CAC volume.
Study context
- Population
- Asymptomatic individuals undergoing noncontrast coronary artery calcium (CAC) scoring CT
- Participants
- 21,346 individuals · 5 studies · 6 cohorts
- Comparison
- Higher vs lower CAC density
- Outcome
- CV events:
- CVD
- CHD events
- Follow-up
- Median 5.2 to 16.7 years
Pooled result
CV events per SD of CAC density
Hazard ratio
0.80 per SD of density
95% CI 0.72–0.89
P < 0.01
CAC density (per SD)
HR 0.80 per SD of density (95% CI 0.72–0.89); P < 0.01
Per SD, as printed
As reported in the abstract
- CV events
- 1,309 (6.1%)
Further pooled results
| Outcome | HR (per SD) (95% CI) | P value | |
|---|---|---|---|
| CVD vs CHD events (subgroup) — CAC density (per SD) · CVD events | 0.80 (0.71–0.90) | ||
| CVD vs CHD events (subgroup) — CAC density (per SD) · CHD events | 0.74 (0.59–0.94) | ||
| CV events by statin use (subgroup) — CAC density (per SD) · statin-naive | 0.79 (0.70–0.89) | P < 0.01 | |
| CV events by statin use (subgroup) — CAC density (per SD) · statin-treated | 0.97 (0.77–1.22) | P = 0.78 | |
| 0.512Hazard ratio (log scale) |
- Cardiovascular disease (CVD) vs coronary heart disease (CHD) events (subgroup): no significant difference, P = 0.59
- CV events by statin use (subgroup): interaction P = 0.12
Original publication
Coronary Artery Calcium Density and Risk of Cardiovascular Events. JACC Cardiovasc Imaging. Published 4 September 2024. doi:10.1016/j.jcmg.2024.07.024
Summarised from the published abstract; every number is checked against it