Fluoroscopic Detection of Coronary Artery Calcification may Predict Long-Term Mortality

Alberto Caccavo, Rubén L. Brodsky, Florencia Rolandi, Francisco Caccavo


Introduction: Coronary artery calcification is a marker of atherosclerosis. Fluoroscopy is a simple and accessible method todetect coronary artery calcification.

Objective: The aim of this study was to evaluate the value of fluoroscopic detection of coronary artery calcification as anindependent predictor of all-cause mortality and cardiovascular mortality in the long-term.

Methods: A prospective cohort of persons ≥45 years without documented cardiovascular disease underwent fluoroscopicexamination to identify the presence of coronary artery calcification.A Cox regression model was used to evaluate the independent effect of calcification as a predictor of mortality in the long-term.

Results: A total of 857 persons were included. Follow-up was completed in 98.7% of cases with an average of 14.4 ± 4.3 years(range: 34 days to 20.8 years). Mean age was 61.3 ± 9.7 years, 88.9% had hypertension, 19.6% had high cholesterol levels,1.8% were diabetics and 52.7% were men. Coronary artery calcification was detected in 264 patients (32%). The presence ofcoronary artery calcification was associated with age, male sex and high cholesterol levels.All-cause long-term mortality was 28.3% and cardiovascular mortality was 14.9%.The presence of coronary artery calcification was an independent predictor of all-cause mortality (HR 1.6, 95% CI 1.2-2.0;p = 0.002) and of cardiovascular mortality (HR 2.5, 95% CI 1.6-3.9; p = 0.002). All-cause mortality without calcification was1.35 per 100 patient-years and 3.39 per 100 patient-years with calcification [p (log rank test) < 0.0001].

Conclusion: Fluoroscopic detection of coronary artery calcification may predict all-cause mortality and cardiovascular mortalityin the long-term in a population without documented cardiovascular disease.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar