Coronary Calcium Score in Mortality, Hospital Admissions with ACS and Need for Revasularization: A Retrospective Observational Study

Objective: Cardiovascular disorders (CVD) are a leading cause of death in the world. Further, the identification of acute coronary syndrome (ACS) patients without any symptoms is a very crucial and important task. At present, the coronary artery calcium (CAC) scoring system has been developed to predict future risk of CVD. The present study is focused on the assessment of mortality, hospital admissions with ACS and need for revascularization on the basis of calcium score.

Methods: A retrospective observational study was conducted on the patients with stable angina or anginal equivalents like dyspnea on exertion history who visited Amrita Institute of Medical Sciences from January 2012 to December 2020 and underwent MDCT CAG and MDCT CAC assessment. Moreover, the patients with ACS such as unstable angina, NSTEMI or STEMI or who had undergone PTCA or CABG in past were excluded.

Results: A total of 459 patients were studied and the mean age of the study population was found 54.77±12.29 years. A total of 71% of patients were male and total of 8 patients had been found to develop ACS on follow up (NSTEMI or AWMI or IWMI). Furthermore, a total of 3 patients had severe coronary calcification while only 2 patients had mild and 2 patients moderate coronary calcification scores. These results showed that higher calcium score was associated with higher chances of ACS on follow up while number of patients requiring intervention (PTCA or CABG) were higher in moderate or severe coronary calcification group as compared to patients with zero or mild calcification group. Primary endpoint of mortality did not show any statistical difference between the all 4 groups.

Conclusion: It was concluded that the early detection of patients with CAD by calcium scoring system will help in the real time prediction of ACS and play a role in the management of healthy lifestyle.