P4577Coronary artery calcium score and the long-term risk of atrial fibrillation in patients undergoing non-contrast cardiac computed tomography for suspected coronary artery disease

Background: Use of non-contrast cardiac computed tomography (nCCT) and the Agatston score method has identified coronary artery calcium score (CACS) as a compelling predictor of cardiovascular events. However, there is limited information about the relationship between CACS and atrial fibrillation (AF). Purpose: To examine the association between coronary artery calcium score and risk of future AF and to estimate the predictive accuracy of CACS for AF development in patients undergoing non-contrast cardiac computed tomography. Methods: We conducted a historical population-based cohort study of 25,787 patients suspected of having coronary artery disease and without a history of AF. The patients were identified in the Western Denmark Heart Registry, which is a validated clinical quality database covering Western Denmark. The patients underwent nCCT between 2010 and 2015, where the CACSs were measured. They were followed for the development of AF until 2016 (median 3.0 years). We used Cox proportional hazards models to estimate hazard ratios (HR) with 95% confidence intervals (95% CI). The outcome was an incident AF diagnosis. A receiver operating characteristic (ROC) curve for AF was used to assess the predictive accuracy of different CACS cut-off values.