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Global Molecular Calcium Score: New Tool in Cardiovascular Risk Assessment?
Session:
Sessão de Posters 16 - Mapeamento do risco: dos scores ao cálcio
Speaker:
Mafalda de Oliveira Griné
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.2 Risk Factors and Prevention – Cardiovascular Risk Assessment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Mafalda Oliveira Grine; Rita Bertão Ventura; Manuel Oliveira-Santos; João Borges-Rosa; Rodolfo Silva; Andreia Gomes; Antero Abrunhosa; Miguel Castelo-Branco; Lino Gonçalves; Maria João Ferreira
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">BACKGROUND</span></strong><span style="font-family:Calibri,sans-serif">: Positron emission tomography computed tomography with 18F sodium fluoride (18F-NaF-PET-CT) detects active microcalcification, a marker of atherosclerotic plaque instability. We sought to explore the association between increased 18F-NaF uptake and cardiovascular (CV) events. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">METHODS</span></strong><span style="font-family:Calibri,sans-serif">: We conducted a patient-level outcomes analysis of the ROPPET-NAF trial (<em>Rosuvastatin Effect on Atherosclerotic Plaque Metabolism – a Subclinical Atherosclerosis Imaging Study With <sup>18</sup>F–NaF PET-CT</em>: NCT 03233243) and its pilot study, in which high CV risk individuals underwent 18F-NaF-PET-CT. Total cardiac 18F-NaF uptake was measured as global molecular calcium score (GMCS). The primary endpoint was defined as the composite of CV death, nonfatal myocardial infarction, nonfatal stroke, or heart failure hospitalization. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">RESULTS</span></strong><span style="font-family:Calibri,sans-serif">: A total of 57 participants were included in this analysis. Mean age was 64 years, 63% were male, most had hypertension (96%) and diabetes (82%). Over a median of approximately 4 years, 8 patients (14%) experienced the primary endpoint: 4 nonfatal strokes, 3 heart failure hospitalizations, 1 fatal myocardial infarction. There was also one case of unplanned arterial revascularization. Among participants who experienced an event, diabetes was less frequent, there was a higher median systolic blood pressure and more current smokers. Median GMCS was significantly higher in the group with CV events (187 (134, 288) vs. 413 (339, 537); p<0.001. Increased cardiac microcalcification activity was associated with the primary composite endpoint (HR: 1.085; 95% CI: 1.023-1.151; p = 0.007) and the association remained after multivariate adjustment (HR 1.174; 95% CI: 1.020-1.351; p = 0.026). According to maximally selected rank statistics, the optimal GMCS cut-off would be 400.67. According to variable importance analysis (survival random forest model), GMCS was the most significant predictor variable.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:"Times New Roman",serif"><span style="color:#000000"><strong><span style="font-family:Calibri,sans-serif">CONCLUSION</span></strong><span style="font-family:Calibri,sans-serif">: In this patient-level analysis of the ROPPET-NAF trial and its pilot study, GMCS was associated with CV events. As we shift from the "vulnerable plaque" to the "vulnerable patient" paradigm, GMCS is a promising tool to refine CV risk stratification.</span></span></span></span></p>
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