Prevention & lipids

Coronary Artery Calcium Density and Risk of Cardiovascular Events: A Systematic Review and Meta-Analysis

JACC Cardiovasc ImagingPublished Systematic review and meta-analysis

Pooled result · CV events per SD of CAC densityResult — go to the resultHazard ratio 0.80 per SD of density 95% CI 0.72–0.89

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 individuals5 studies6 cohorts
Comparison
Higher vs lower CAC density
Outcome
CV events:
  • CVD
  • CHD events
Follow-up
Median 5.2 to 16.7 years
Methodological detailsrandom-effects
  • Random-effects

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

OutcomeHR (per SD) (95% CI)P value
CVDvs CHD events (subgroup)CAC density (per SD) · CVD events0.80 (0.71–0.90)
CVDvs CHD events (subgroup)CAC density (per SD) · CHD events0.74 (0.59–0.94)
CV events by statin use (subgroup)CAC density (per SD) · statin-naive0.79 (0.70–0.89)P < 0.01
CV events by statin use (subgroup)CAC density (per SD) · statin-treated0.97 (0.77–1.22)P = 0.78
  • 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: A Systematic Review and Meta-Analysis. JACC Cardiovasc Imaging. Published 4 September 2024. doi:10.1016/j.jcmg.2024.07.024

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