Coronary Calcium Predicts Myocardial Infarction in Asymptomatic Subjects After Two Years of Follow-up

Coronary calcium (CC) has been shown to be associated with increased prevalence of coronary heart disease events including angin and revascularization in high risk adults. However, conclusive evidence of an association with myocardial infarction (MI) and coronary heart disease death (CHDD) has been lacking. We screened 1461 high risk asymptomatic subjects using digital fluoroscopy between Nov. 1990 and April 1992 and found that 59% had CC. Standard risk factors were determined and no subject had prior MI or angin pectoris at screening. After 27 ± 10 months, follow-up had been completed in 99.6% of subjects. Fifteen subjects had suffered CHDD and 28 had suffered MI. CHDD was four times as frequent in those with than in those without CC (p = 0.07). MI occurred in 23 subjects with and in 5 without CC (p = 0.02). Multivariable analysis showed that CC contributed independently to the probability of MI. CC does predict MI and may predict CHDD in high risk asymptomatic adults.