Abstract 4147143: The value of high coronary artery calcium score (CACS) in prediction of stroke incidence.

Introduction: In multiple recent studies, a higher coronary artery calcium score (CACS) has been associated with a higher risk of MACE and all-cause mortality. The relationship between coronary artery calcium (CAC) and the incidence of stroke is poorly defined. Method: Patients were obtained from the Sanford heart screening program from April 25, 2011 through June 23, 2023. The sample was limited to only those who underwent a CACS. A high CACS was deemed as anything greater than or equal to 300, whereas anything lower was identified as non-high CACS. The odds ratio was calculated via multiple logistic regression to analyze the data. Results: A total of 33249 patients with CACS were analyzed in this study. The average age of the patients is 56.19 (SD =9.97) and 46% of them are male. Among all the patients in the study, 3529 had a high CACS, of which 399 of them had stroke (11.3%). Our study shows that there is a positive effect between a high CACS and the incidence of stroke. The odds of having stroke are predicted to be 1.95 times larger in patients with high CACS (P-value < 0.001). In comparison to the patients who smoke frequently, the odds of developing a stroke shrink by a factor of about 0.53 and 0.48 for patients who do not smoke (P-value < 0.001) and patients who smoke occasionally (P-value=0.003), respectively. Furthermore, a five-year increase in age results in a 32% increase in odds of developing a stroke for patients with CACS less than 300 (P-value < 0.001), and a 17% increase in odds of developing a stroke for patients with high CACS (P-value = 0.006). However, for each additional year after CACS testing, the odds of stroke decreased by 18%, for patients with CACS less than 300 (P-value < 0.001), and 27%, for patients with high CACS (P-value < 0.001), likely due to interventions done. Conclusion: Our study showed that a high coronary artery calcium score predicts an increased incidence of stroke in our patient population.