Coronary artery calcium scoring for cardiovascular risk assessment in patients with inflammatory bowel disease
Authors' conclusion
Subclinical atherosclerosis, as evaluated by CAC scoring, is prevalent in patients with IBD, and is associated with cardiovascular events.
Study context
- Population
- Patients with inflammatory bowel disease (IBD) (ulcerative colitis (UC) or Crohn's disease (CD)) undergoing no-charge coronary artery calcium (CAC) scoring, 2014–2020median age 60 years
- Participants
- 369 patients
- Exposure
- CAC score vs PCE 10-year atherosclerotic cardiovascular disease (ASCVD) risk
- UCn = 174
- CDn = 195
- Outcome
- Concordance between CAC risk (CAC≥100) and 10-year ASCVD risk by AHA/ACC pooled cohort equation (≥7.5%)
Methodological detailssingle-centre registry (CLARIFY)
- Single-centre registry (CLARIFY)
Main finding
As reported in the abstract
- Median CAC score, overall
- 14.9
- Median CAC, UC vs CD
- P = .76
- CAC of 0
- 151 (41%)
- CAC 1-99
- 108 (29%)
- CAC 100 to 399
- 61 (17%)
- CAC ≥400
- 49 (13%)
- CAC distribution, CD vs UC
- P = .17
- No difference in median CAC vs age/sex-matched controls
- P = .34
- 10-year ASCVD risk ≥7.5%
- 52%
- ASCVD risk <7.5% (n = 163) with CAC≥100
- 29 (18%)
- ASCVD risk ≥7.5% (n = 178) with CAC <100
- 102 (57%)
Observational data: associations, not effects.
Further findings
| Outcome | CAC score | PCE ASCVD risk | HR (CI) | P value | |
|---|---|---|---|---|---|
| Prediction of MACECAC ≥76vs CAC <76MACE | 4.0 (2.0–8.1) | P < 0.001 | |||
| AUROC | 0.67 [0.56-0.78] | 0.60 [0.48-0.73] | |||
| Best cut-off | 76 | — not stated in the abstract | |||
| Sensitivity | 60% | — not stated in the abstract | |||
| Specificity | 69% | — not stated in the abstract | |||
| 0.10.31310Hazard ratio (log scale) |
— not stated in the abstract
CAC<100 vs CAC≥100: CRP, immunosuppressive or amino-salicylate therapy, IBD severity or complications
- No difference
Prediction of Major Adverse Cardiovascular Events (MACE)
- CAC score, but not PCE ASCVD risk, was predictive of MACE
Original publication
Coronary artery calcium scoring for cardiovascular risk assessment in patients with inflammatory bowel disease. Am Heart J. Published 25 August 2023. doi:10.
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