Impact of coronary artery calcium scores on cardiovascular risk and preventive therapies: A systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 41978656 · doi:10.21542/gcsp.2025.48
What was done
A systematic review and meta-analysis following PRISMA guidelines searched PubMed, Scopus, Google Scholar, Cochrane Central, and ClinicalTrials.gov through February 2025. Investigators analyzed 53 observational studies encompassing 210,672 asymptomatic and 32,477 symptomatic individuals without known coronary artery disease, comparing participants with a coronary artery calcium (CAC) score > 0 versus CAC = 0 across an average follow-up of 8.6 years for clinical outcomes and preventive therapy uptake.
What was found
The presence of CAC was significantly associated with higher risks of major adverse cardiovascular events (OR: 5.58), all-cause mortality (OR: 3.90), myocardial infarction (OR: 4.01), and revascularization (OR: 11.90). CAC presence also correlated with greater odds of initiating and maintaining preventive pharmacotherapies (aspirin, lipid-lowering, and antihypertensive agents) and adopting positive lifestyle modifications (diet and physical activity), though numeric effect sizes for therapy and lifestyle outcomes were not reported in the abstract.
Why it matters
This meta-analysis reinforces detectable coronary calcification as a robust prognostic indicator for hard cardiovascular outcomes and demonstrates that CAC detection actively prompts both pharmacological treatment and patient lifestyle adherence.
Limits
All included studies were observational rather than randomized trials evaluating screening efficacy. Confidence intervals, metrics of between-study heterogeneity, and separate risk estimates for asymptomatic versus symptomatic subgroups were not provided in the abstract.
Cited by
- supports The coronary artery calcification (CAC) score is a strong predictor of mortality.