Using Coronary Artery Calcium to Predict Cardiovascular Events in COPD

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The CAC score may be a better predictor for cardiovascular events in patients with COPD than the Framingham index.
The CAC score may be a better predictor for cardiovascular events in patients with COPD than the Framingham index.

Coronary artery calcium (CAC) may be the best noninvasive risk marker for predicting a major cardiovascular event in patients with chronic obstructive pulmonary disease (COPD), according to a study published in Respiratory Research.

Researchers prospectively evaluated 287 individuals with COPD and a history of current or past smoking of at least 10 pack years for a median of 65 months to evaluate the prognostic value of noninvasive risk markers in patients with COPD. 

A univariable analysis demonstrated that age, hypertension, low-density lipoprotein cholesterol, total cholesterol, C-reactive protein levels, and coronary calcium score were all noninvasive CV risk markers independently associated with the risk for a major CV event with P values of .001. 

However, the multivariable analysis demonstrated CAC as measured by a low-dose chest computed tomography scan was best for independently predicting the risk for a major cardiovascular event in patients with COPD compared with the Framingham score (hazard ratio; 95% CI, 1.32; 1.19-1.46, P <.001).   

The investigators concluded that clinicians should consider incorporating CAC levels to identify patients at high risk for a major cardiovascular event.

Reference

Zagaceta J, Bastarrika G, Zulueta J, et al.  Prospective comparison of non-invasive risk markers of major cardiovascular events in COPD patients. Respir Res.  2017;18(1):175.

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