Abstract 16701: Conventional Cardiovascular Risk Modifies Clinical Outcomes Among Subjects With Elevated Coronary Artery Calcium Score With and Without Statin Therapy: Post Hoc Analysis From the St Francis Heart Study

Objective: Coronary artery calcium score (CAC) predicts cardiovascular (CV) risk independent of conventional risk profile. However, it remains unclear how clinical risk profile modifies CV outcomes among subjects with elevated CAC with and without lipid lowering therapy. Methods: We conducted a post hoc analysis of the treatment trial of the St. Francis Heart Study_double-blind, placebo-controlled randomized clinical trial of atorvastatin 20 mg, vitamin C 1 g, and vitamin E 1,000 U daily, versus matching placebos in 993 asymptomatic individuals with CAC at or above the 80th percentile for age and gender. Primary CV outcomes included non-fatal MI or coronary death, coronary revascularization, stroke, and peripheral arterial revascularization. Among the placebo and treatment groups, we further stratified by eligibility for statin therapy based on current AHA guidelines yielding 4 subgroups: treated not eligible (+Rx/-E), placebo not eligible (-Rx/-E), treated eligible (+Rx/+E) and placebo eligible (-Rx/+E)....