Coronary calcium scores effectively predict risk of heart attack and overall mortality in both women and men: Study

Coronary artery calcium (CAC) scores have become a non-invasive way for physicians to easily determine how much plaque has built up inside a patient’s coronary arteries, but the question has been how accurate the score is in identifying women, as well as men, who are at high risk for a heart attack or death.

Now, a major new study by researchers at Intermountain Health in Salt Lake City finds coronary artery calcium scores are not only highly effective in identifying those at risk for future heart attacks, but also for death, and risk prediction was found to be as good in women as in men.

Results from the Intermountain Health study found that in addition to predicting risk of coronary death and non-fatal heart attacks, coronary artery calcium scores also correlated to all-cause mortality. Researchers found that people with a score of zero were three times less likely to die from any cause.

“The coronary artery calcium score appears to be an excellent and accurate indicator of health and overall prognosis, even beyond heart disease,” said Jeffrey L. Anderson, principal investigator of the study and distinguished research physician at Intermountain Health.

Findings from the Intermountain Health study were presented at the American Heart Association National Scientific Sessions 2024 in Chicago on Monday, Nov. 18, 2024.

Coronary artery calcium testing is becoming more common in heart healthcare. These tests are non-invasive, use as little radiation as a mammogram, and are relatively cheap, especially compared to PET stress tests, coronary CT angiograms, or coronary angiography.

For the Intermountain Health study, researchers reviewed the electronic health records of 19,495 women and 20,523 men who had undergone PET/CT scans because their physicians suspected they had a risk of heart disease, but who hadn’t yet had a heart event, such as a heart attack.

Of these patients, 7,967 had a CAC score of zero, meaning they had no calcified plaque in their coronary arteries. Of this group, women on average were older than men (60.5 years for women, 53.8 for men), which correlates to how women often develop heart disease later in life than men, Dr. Anderson said.

Researchers then followed up on patients about two years later. They found that a zero CAC score predicted a low risk for coronary death or nonfatal heart attacks in both men and women. CAC scores of zero were more frequently observed in women despite having an older average age.

Intermountain researchers also found that those with a zero CAC had three times lower risk of all-cause death or heart attack in both sexes.

While it’s obvious why a CAC score of zero would be a good indicator of heart health, its ability to predict all-cause mortality is novel and deserves additional study.

“We will be exploring this further to understand better why a zero-calcium score is such a good signal to overall health,” said Dr. Anderson.

Reference:

New study finds prognostic value of coronary calcium scores effective in predicting risk of heart attack and overall mortality in both women and men, Intermountain Healthcare, Meeting: AHA Scientific Sessions 2024.