Prevalence and Burden of Coronary Artery Calcium Across the Pooled Cohort Equation versus the American Heart Association PREVENT Risk Calculator
Abstract Body (Do not enter title and authors here): Background The 2013 Pooled Cohort Equation (PCE) has been a useful starting point to assess atherosclerotic cardiovascular disease (ASCVD) risk. In 2023, the PREVENT risk calculator was developed and validated as a contemporary calculator considering the cardiovascular-kidney-metabolic health paradigm. Coronary artery calcium (CAC), measured on non-contrast cardiac computed tomography (CT), improves ASCVD risk stratification beyond traditional risk factors. However, the prevalence of CAC burden across PCE versus PREVENT risk groups is unknown.
Hypothesis We hypothesized that there would be a higher CAC burden for PREVENT vs PCE calculated risk across low, borderline-intermediate, and high-risk groups.
Methods This retrospective study included 6,003 asymptomatic individuals who underwent CAC scoring for ASCVD risk stratification from 2010-2023 at Emory. The 10-year risk for ASCVD according to PCE and base PREVENT were retrospectively calculated. CAC was quantified using the Agatston method. CAC scores across PREVENT and PCE groups were compared using Chi-square tests, using CAC (0, 1-99, 100-299, ≥300) and PCE/PREVENT (low<5, borderline-intermediate 5-19, high≥20%) 10-year risk categories. Concordant/discordant groups were created according to agreement between PCE and PREVENT (>7.5 PCE/PREVENT <7.5).
Results The mean age 57(9), 41% were women, and 11% were Black people. PCE classified 51.8% (n=3112) low, 41.5% (n=2490) borderline-intermediate, and 6.7% (n=401) high-risk participants, whereas PREVENT classified 72.1% (n=4329) low, 27.3% (n=1641) borderline-intermediate, and 0.6% (n=33) high-risk participants. Among participants, 41.2% (n= 2474) had CAC=0, 36.5% (n=2189) had 1-99, 11.4% (n=687) had 100-299, and 10.9% (n=653) had ≥300 CAC. For both PCE and PREVENT, higher risk groups had higher median CAC. CAC distribution was heterogeneous across risk categories within both PCE and PREVENT, and between PCE and PREVENT (p<0.001). CAC prevalence was 72% and 81% for individuals with borderline-intermediate risk according to PCE and PREVENT, respectively. Median CAC scores were similar across discordant PCE/PREVENT risk groups (33 (1-201) vs 29 (1-201)).
Conclusion The prevalence of CAC was similar across calculated PCE and PREVENT risk groups, including individuals with borderline-intermediate risk. These results underline the continued utility of CAC at improving risk stratification beyond PCE and PREVENT.
Gershon, Gabrielle
( Emory University
, Atlanta
, Georgia
, United States
)
Van Assen, Marly
( Emory University
, Atlanta
, Georgia
, United States
)
Razavi, Alexander
( Emory University
, Atlanta
, Georgia
, United States
)
Yang, Yan
( Emory University
, Atlanta
, Georgia
, United States
)
Dzaye, Omar
( JOHNS HOPKINS UNIVERSITY
, Baltimore
, Maryland
, United States
)
Whelton, Seamus
( JOHNS HOPKINS
, Baltimore
, Maryland
, United States
)
Blaha, Michael
( JOHNS HOPKINS HOSPITAL
, Baltimore
, Maryland
, United States
)
Blumenthal, Roger
( JOHNS HOPKINS
, Baltimore
, Maryland
, United States
)
Sperling, Laurence
( EMORY UNIV
, Atlanta
, Georgia
, United States
)
De Cecco, Carlo
( Emory University
, Atlanta
, Georgia
, United States
)
Author Disclosures:
Gabrielle Gershon:DO NOT have relevant financial relationships
| Marly van Assen:DO have relevant financial relationships
;
Research Funding (PI or named investigator):Siemens:Active (exists now)
; Research Funding (PI or named investigator):Cleerly:Active (exists now)
; Researcher:Pfizer:Active (exists now)
| Alexander Razavi:No Answer
| Yan Yang:No Answer
| Omar Dzaye:DO NOT have relevant financial relationships
| Seamus Whelton:DO NOT have relevant financial relationships
| Michael Blaha:DO have relevant financial relationships
;
Research Funding (PI or named investigator):Bayer:Active (exists now)
; Advisor:New Amsterdam:Expected (by end of conference)
; Advisor:Vectura:Past (completed)
; Advisor:Agepha:Active (exists now)
; Advisor:Astra Zeneca:Past (completed)
; Advisor:Eli Lilly:Active (exists now)
; Advisor:Boehringer Ingelheim:Active (exists now)
; Advisor:Roche:Past (completed)
; Advisor:Merck:Past (completed)
; Advisor:Bayer:Active (exists now)
; Advisor:Novartis:Active (exists now)
; Advisor:Novo Nordisk:Active (exists now)
; Researcher:Amgen:Past (completed)
| Roger Blumenthal:DO NOT have relevant financial relationships
| Laurence Sperling:DO NOT have relevant financial relationships
| Carlo De Cecco:DO have relevant financial relationships
;
Research Funding (PI or named investigator):Siemens:Active (exists now)
; Consultant:Xeos:Past (completed)
; Advisor:Bayer:Past (completed)
; Research Funding (PI or named investigator):Cleerly:Active (exists now)
; Research Funding (PI or named investigator):Elucid:Active (exists now)
