Coronary calcium score predicts coronary events in four ethnic groups

27 March 2008

MedWire News: Coronary calcium score strongly predicts incident coronary heart disease in White, Black, Hispanic, and Chinese individuals, findings from a large follow-up study show.

Coronary calcium score has previously been shown to predict coronary heart disease, independent of standard risk factors, in White populations. However, less is known about its relevance in other ethnic groups.

Robert Detrano (University of California at Irvine, USA) and colleagues recruited 6722 men and women aged between 45 and 84 years from the Multi-Ethnic Study of Atherosclerosis (MESA) to investigate this further.

The study cohort consisted of 38.6% White, 27.6% Black, 21.9% Hispanic, and 11.9% Chinese individuals.

The investigators measured coronary calcium and calculated scores for all participants, who were then followed up for an average of 3.8 years. In total, 162 coronary events were recorded over this period, including 89 major events (myocardial infarction or death).

The results of this research, published in the New England Journal of Medicine, show that coronary calcium scores of 101-300 increase the risk for a coronary event by a factor of 7.73, and a factor of 9.67 for scores above 300, in comparison with coronary calcium scores of 0.

Detrano and team say: "A doubling of the calcium score increased the estimated probability of both major coronary events (myocardial infarction and death from coronary heart disease) and any coronary event by approximately 25% during a median follow-up period of 3.8 years."

When the results for the four ethnic groups were separated, the calcium score was found to be a relevant predictor for all groups and no major differences were seen among them.

The researchers suggest that their results show "that the coronary calcium score is valuable for the prediction of future cardiac events even in ethnic groups in which coronary calcification is less prevalent."

N Engl J Med 2008; 358: 1336-1345