{"id":21610,"date":"2025-02-28T11:46:22","date_gmt":"2025-02-28T16:46:22","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21610"},"modified":"2025-03-13T11:52:03","modified_gmt":"2025-03-13T15:52:03","slug":"impact-of-zero-coronary-artery-calcium-scoring-on-downstream-cardiac-testing-and-cardiac-outcomes-compared-with-no-testing","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/impact-of-zero-coronary-artery-calcium-scoring-on-downstream-cardiac-testing-and-cardiac-outcomes-compared-with-no-testing\/","title":{"rendered":"Impact of zero coronary artery calcium scoring on downstream cardiac testing and cardiac outcomes compared with no testing"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 The impact of coronary artery calcium (CAC) scoring on downstream resource utilisation and outcomes remains unclear, especially in those with zero CAC.<\/p>\n<p><strong>Methods<\/strong> \u2014 Consecutive CAC scores from two academic hospitals in Toronto, Ontario, were linked to population-based databases. Subjects with zero CAC without previous cardiovascular disease were propensity score matched with a non\u2013CAC-tested control group for age, sex, cardiovascular risk factors, and comorbidities. Downstream cardiac testing, acute myocardial infarction, heart failure (HF) hospitalisations, and HF emergency department (ED) visits were compared between the 2 groups.<\/p>\n<p><strong>Results<\/strong> \u2014 A total of 4884 patients underwent CAC scoring, of whom 2709 had zero CAC (mean 52.9 \u00b1 10.6 years), 55.4% women. At 3.4 years, graded-stress testing (hazard ratio [HR] 1.24, 95% confidence interval [95% CI] 1.14-1.35), stress echocardiography (HR 1.80, 95% CI 1.59-2.05), and cardiac magnetic resonance imaging (HR 3.40, 95% CI 2.55-4.53) use was higher in the zero CAC group, whereas myocardial perfusion scintigraphy (HR 1.08, 95% CI 0.97-1.21) and catheterisation (HR 1.14, 95% CI 0.91-1.44) were similar and percutaneous coronary intervention (HR 0.58, 95% CI 0.35-0.98) and coronary artery bypass grafting (HR 0.14, 95% CI 0.03-0.61) were lower. There was an approximately 5-fold lower rate of myocardial infarction (HR 0.22, 95% CI 0.10-0.51) in the zero CAC group and no difference in HF hospitalisations (HR 1.15, CI 95% 0.53-2.48) or ED admissions (HR 1.21, 95% CI 0.58-2.52).<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Our results support the utility of zero CAC in limiting interventional cardiovascular procedures while maintaining an association with reduced downstream cardiovascular events.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 The impact of coronary artery calcium (CAC) scoring on downstream resource utilisation and outcomes remains unclear, especially in those with zero CAC. Methods \u2014 Consecutive CAC scores from two academic hospitals in Toronto, Ontario, were linked to population-based databases. Subjects with zero CAC without previous cardiovascular disease were propensity score matched with a [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,35],"migration-helper-qa-sample-set":[],"class_list":["post-21610","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-public-health"],"acf":{"citation":"Lin E, Alonzo R, Fang J, Chu A, Elhadad L, Sud M, Wijeysundera HC, Basque S, Hanneman K, Nguyen E, Farkouh ME, Udell JA, Roifman I. <em>CJC Open<\/em>. 2025; 7(2):211-220. Epub 2024 Nov 18.","source_url":"https:\/\/doi.org\/10.1016\/j.cjco.2024.11.009","ices_scientist":[1133,1346,1334],"site":[6733],"research_program":[6742],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Impact of zero coronary artery calcium scoring on downstream cardiac testing and cardiac outcomes compared with no testing<\/title>\n<meta name=\"description\" content=\"Background \u2014 The impact of coronary artery calcium (CAC) scoring on downstream resource utilisation and outcomes remains unclear, especially in those with\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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