Frontiers in Cardiovascular Medicine (Jul 2021)

Prognostic Value of Coronary Artery Calcium Score in Hospitalized COVID-19 Patients

  • Maria-Luiza Luchian,
  • Stijn Lochy,
  • Andreea Motoc,
  • Dries Belsack,
  • Julien Magne,
  • Julien Magne,
  • Bram Roosens,
  • Johan de Mey,
  • Kaoru Tanaka,
  • Esther Scheirlynck,
  • Sven Boeckstaens,
  • Karen Van den Bussche,
  • Tom De Potter,
  • Berlinde von Kemp,
  • Xavier Galloo,
  • Clara François,
  • Caroline Weytjens,
  • Steven Droogmans,
  • Bernard Cosyns

DOI
https://doi.org/10.3389/fcvm.2021.684528
Journal volume & issue
Vol. 8

Abstract

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Background: The association of known cardiovascular risk factors with poor prognosis of coronavirus disease 2019 (COVID-19) has been recently emphasized. Coronary artery calcium (CAC) score is considered a risk modifier in the primary prevention of cardiovascular disease. We hypothesized that the absence of CAC might have an additional predictive value for an improved cardiovascular outcome of hospitalized COVID-19 patients.Materials and methods: We prospectively included 310 consecutive hospitalized patients with COVID-19. Thirty patients with history of coronary artery disease were excluded. Chest computed tomography (CT) was performed in all patients. Demographics, medical history, clinical characteristics, laboratory findings, imaging data, in-hospital treatment, and outcomes were retrospectively analyzed. A composite endpoint of major adverse cardiovascular events (MACE) was defined.Results: Two hundred eighty patients (63.2 ± 16.7 years old, 57.5% male) were included in the analysis. 46.7% patients had a CAC score of 0. MACE rate was 21.8% (61 patients). The absence of CAC was inversely associated with MACE (OR 0.209, 95% CI 0.052–0.833, p = 0.027), with a negative predictive value of 84.5%.Conclusion: The absence of CAC had a high negative predictive value for MACE in patients hospitalized with COVID-19, even in the presence of cardiac risk factors. A semi-qualitative assessment of CAC is a simple, reproducible, and non-invasive measure that may be useful to identify COVID-19 patients at a low risk for developing cardiovascular complications.

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