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

Journal Contribution - Journal Article

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.

Journal: Frontiers in Cardiovascular Medicine
ISSN: 2297-055X
Volume: 8
Publication year:2021
Keywords:Corona virus, chest computed tomography, coronary artery calcium score, major adverse cardiac and cerebral event, risk stratification
  • Scopus Id: 85126545999
  • WoS Id: 000675620400001
  • ORCID: /0000-0001-5308-8729/work/98612369
  • ORCID: /0000-0002-9168-2398/work/98611726
  • ORCID: /0000-0002-0871-8303/work/98611724
  • ORCID: /0000-0002-3601-3212/work/98611612
  • ORCID: /0000-0003-3985-3249/work/98611285
  • ORCID: /0000-0002-8652-2859/work/98610981
  • ORCID: /0000-0001-5533-3185/work/98610824
  • DOI: https://doi.org/10.3389/fcvm.2021.684528
  • Institutional Repository URL: https://cris.vub.be/ws/files/87775852/73500970.pdf
  • PubMed Central Id: PMC8301217
BOF-keylabel:yes
IOF-keylabel:yes
BOF-publication weight:3
Authors:International
Authors from:Higher Education
Accessibility:Open