Abstract 12604: Coronary Artery Calcium Score Determined From Pre-Ablation Pulmonary Vein Computed Tomography Allows for Diagnosis of Coronary Artery Disease and Improved Atherosclerotic Cardiovascular Disease Risk Prediction

Objective: Coronary artery calcification (CAC) is a useful adjunct for atherosclerotic cardiovascular disease (ASCVD) risk stratification and can influence preventive strategies. However, CAC screening is infrequently done, even among cardiology patients. Ancillary imaging, for example pulmonary vein CT (CTPV) performed prior to atrial arrhythmia ablation, may allow for CAC quantification. Our goal was to assess CAC prevalence on pre-ablation CTPVs and to assess how this information could influence risk stratification. Methods: Patients undergoing atrial arrhythmia ablation at NYU from 4/1/18 to 4/30/19 were identified and all available medical records reviewed. CTPVs were reviewed and CAC graded semi-quantitatively (0, 1-9, 10-99, 100-399, 400-999, 1000+). 10-yr ASCVD and MESA scores were calculated for patients without known ASCVD. Results: 739 patients underwent ablations and 660 had CTPV available for assessment. Mean age was 63.4 ± 11.4 years, 33.9% were female, and 17.1% had a history of ASCVD (prior MI, CVA/TIA, CAD, PAD). CAC was present in 62% of patients, including 57.2% without ASCVD history (22.3% of these had CAC ≥100). Complete data for the calculation of 10-year AHA/ACC and MESA risk scores were present in 27.9% and 32.4%, respectively. MESA CHD risk score allows for the incorporation of CAC for improved predictive capacity. Median MESA risk was 6.5% without and 6.7% with median CAC included. Incorporating CAC into MESA risk decreased risk in 110 patients (79 of these had CAC <10), and increased risk in 102 patients (101 had CAC ≥10) ( Figure ). AHA/ACC ASCVD risk distribution is displayed in Figure. Guidelines recommend consideration of statins in those with ASCVD risk <7.5% and non-zero CAC. 52.4% of patients with ASCVD risk <7.5 had non-zero CAC ( Figure ) with 18.2% on a statin at the time of their procedure. Conclusion: Quantification of CAC on CTPV can provide a means to diagnose CAD, improve risk stratification and impact primary preventive treatment.