J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 12, Number 10, October 2020, pages 662-667

A Coronary Artery Calcium Score of Zero in Patients Who Have Undergone Coronary Computed Tomography Angiography Is Associated With Freedom From Major Adverse Cardiovascular Events

Figure 1. %CAD (a), number of VD (b), CACS (c) and Gensini score (d) in the CACS = 0 and CACS > 0 groups. CAD: coronary artery disease; number of VD: number of significantly stenosed coronary vessels; CACS: coronary artery calcium score.

Figure 2. (a) %MACE in the CACS = 0 and CACS > 0 groups. (b) Kaplan-Meier curves for freedom from MACE in the CACS = 0 and CACS > 0 groups. MACE: major adverse cardiovascular events; CACS: coronary artery calcium score.

**Table 1.** Patient Characteristics and Medications in the CACS = 0 and CACS > 0 Groups
	CACS = 0 group (n = 202)	CACS > 0 group (n = 300)	P value (CACS = 0 vs. CACS > 0
Continuous variables are expressed as mean ± SD. BMI: body mass index; VFA, visceral fat area; HTN: hypertension; SBP: systolic blood pressure; DBP: diastolic blood pressure; DM: diabetes mellitus; HbA1c: hemoglobin A1c; FBG: fasting blood glucose; DL: dyslipidemia; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; ARB/ACEI: angiotensin II receptor blocker/angiotensin-converting enzyme inhibitor; CCB: calcium channel blocker; DPP-4I: dipeptidyl peptidase-4 inhibitor
Age, years	62 ± 12	69 ± 9	< 0.0001
Gender (male), n (%)	79 (39)	171 (57)	< 0.0001
Family history, n (%)	49 (25)	74 (25)	0.917
Smoking, n (%)	53 (26)	124 (41)	0.001
BMI, kg/m²	23.7 ± 3.5	24.2 ± 3.6	0.104
VFA, mm²	116 ± 55	115 ± 57	0.819
HTN, n (%)	113 (56)	236 (79)	< 0.0001
SBP, mm Hg	131 ± 16	139 ± 20	< 0.0001
DBP, mm Hg	77 ± 12	77 ± 12	0.522
DM, n (%)	32 (16)	83 (28)	0.002
HbAlc, %	5.8 ± 1.1	6.0 ± 1.2	0.059
FBG, mg/dL	106 ± 34	111 ± 34	0.073
DL, n (%)	112 (55)	207 (69)	0.002
TG, mg/dL	135 ± 84	132 ± 88	0.689
HDL-C, mg/dL	57 ± 16	53 ± 14	0.012
LDL-C, mg/dL	113 ± 32	112 ± 30	0.585
Medications
ARB/ACEI, n (%)	57 (28)	142 (47)	< 0.0001
CCB, n (%)	63 (31)	131 (44)	0.005
β-blocker, n (%)	14 (6.9)	35 (12)	0.080
Diuretic, n (%)	14 (6.9)	42 (14)	0.136
Statin, n (%)	48 (24)	133 (44)	< 0.0001
Sulfonylurea, n (%)	9 (4.5)	39 (13)	0.001
Biguanide, n (%)	12 (5.9)	25 (8.3)	0.314
DPP-4I, n (%)	14 (6.9)	43 (14)	0.010
Insulin, n (%)	7 (3.5)	11 (3.7)	0.905

Table 1. Patient Characteristics and Medications in the CACS = 0 and CACS > 0 Groups

CACS = 0 group (n = 202)

CACS > 0 group (n = 300)

P value (CACS = 0 vs. CACS > 0

Continuous variables are expressed as mean ± SD. BMI: body mass index; VFA, visceral fat area; HTN: hypertension; SBP: systolic blood pressure; DBP: diastolic blood pressure; DM: diabetes mellitus; HbA1c: hemoglobin A1c; FBG: fasting blood glucose; DL: dyslipidemia; TG: triglyceride; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; ARB/ACEI: angiotensin II receptor blocker/angiotensin-converting enzyme inhibitor; CCB: calcium channel blocker; DPP-4I: dipeptidyl peptidase-4 inhibitor

Age, years

62 ± 12

69 ± 9

< 0.0001

Gender (male), n (%)

79 (39)

171 (57)

< 0.0001

Family history, n (%)

49 (25)

74 (25)

0.917

Smoking, n (%)

53 (26)

124 (41)

0.001

BMI, kg/m²

23.7 ± 3.5

24.2 ± 3.6

0.104

VFA, mm²

116 ± 55

115 ± 57

0.819

HTN, n (%)

113 (56)

236 (79)

< 0.0001

SBP, mm Hg

131 ± 16

139 ± 20

< 0.0001

DBP, mm Hg

77 ± 12

0.522

DM, n (%)

32 (16)

83 (28)

0.002

HbAlc, %

5.8 ± 1.1

6.0 ± 1.2

0.059

FBG, mg/dL

106 ± 34

111 ± 34

0.073

DL, n (%)

112 (55)

207 (69)

0.002

TG, mg/dL

135 ± 84

132 ± 88

0.689

HDL-C, mg/dL

57 ± 16

53 ± 14

0.012

LDL-C, mg/dL

113 ± 32

112 ± 30

0.585

Medications

ARB/ACEI, n (%)

57 (28)

142 (47)

< 0.0001

CCB, n (%)

63 (31)

131 (44)

0.005

β-blocker, n (%)

14 (6.9)

35 (12)

0.080

Diuretic, n (%)

14 (6.9)

42 (14)

0.136

Statin, n (%)

48 (24)

133 (44)

< 0.0001

Sulfonylurea, n (%)

9 (4.5)

39 (13)

0.001

Biguanide, n (%)

12 (5.9)

25 (8.3)

0.314

DPP-4I, n (%)

14 (6.9)

43 (14)

0.010

Insulin, n (%)

7 (3.5)

11 (3.7)

0.905

**Table 2.** Independent Predictors of MACE by a Multivariate Logistic Regression Analysis
Factors	OR (95% CI)	P value
MACE: major adverse cardiovascular events; OR: odds ratio; CI: confidence interval; VFA: visceral fat area; HTN: hypertension; DM: diabetes mellitus; DL: dyslipidemia; CACS: coronary artery calcium score.
Age	1.013 (0.977 - 1.049)	0.488
Gender (male)	2.091 (0.923 - 4.734)	0.077
VFA	1.001 (0.995 - 1.007)	0.821
Smoking	1.472 (0.710 - 3.053)	0.299
Family history	0.682 (0.287 - 1.623)	0.387
HTN	1.363 (0.609 - 3.052)	0.451
DM	0.973 (0.462 - 2.048)	0.941
DL	0.618 (0.309 - 1.236)	0.173
CACS = 0	0.405 (0.170 - 0.965)	0.041

Table 2. Independent Predictors of MACE by a Multivariate Logistic Regression Analysis

Factors

OR (95% CI)

P value

MACE: major adverse cardiovascular events; OR: odds ratio; CI: confidence interval; VFA: visceral fat area; HTN: hypertension; DM: diabetes mellitus; DL: dyslipidemia; CACS: coronary artery calcium score.

Age

1.013 (0.977 - 1.049)

0.488

Gender (male)

2.091 (0.923 - 4.734)

0.077

VFA

1.001 (0.995 - 1.007)

0.821

Smoking

1.472 (0.710 - 3.053)

0.299

Family history

0.682 (0.287 - 1.623)

0.387

HTN

1.363 (0.609 - 3.052)

0.451

0.973 (0.462 - 2.048)

0.941

0.618 (0.309 - 1.236)

0.173

CACS = 0

0.405 (0.170 - 0.965)

0.041