Background: There
is available data that suggest that the Electron Beam Tomography Scanner (EBCT)
calcium score can help to identify persons at risk of future coronary events.
However, there is limited data on long-term survival among patients with
different coronary calcium scores. We sought to investigate the association
between the degree of coronary calcium score and long-term all-cause mortality.
Methods: We
performed 2213 EBCT between June 1988 and January 1992.
Coronary artery calcification was measured using the Agatston score, and
percentiles were calculated adjusted for age and gender. Total mortality was
assessed through the Social Security Death Registry. Patient out of country were
excluded, (n=430).
Results: Mean
follow-up was 10.4 ±1.2
years (range 0.14 to 11.82 years), that accounted for 17,830 patient-year
survival information. Patients were 48 + 12 yr old.
There were 113 deaths (6.3%). The mean coronary calcium score was 111.4 ±330
units (range 0 to 3891 units). The level of coronary artery calcium score was
associated with an increased total mortality. Kaplan-Meier analysis showed that
patients in the 4th quartile of coronary calcium score were 3.7 times
more likely to die than patients in the 1st quartile, p<0.0001.
This strong association remained significant after controlling for age, diabetes
and other covariates, p=0.0002.
Conclusions:
Patients
with a high degree of coronary artery calcification had a higher long-term
mortality, independent of age. This study suggests that coronary calcium is more
a marker of disease severity than it is a marker of aging.
