In a study in Journal of Cardiac Failure, researchers have discovered that coronary artery calcium (CAC) scoring can effectively predict long-term heart failure (HF) mortality among individuals without symptoms of heart disease.

The study analyzed data from 66,636 adults undergoing CAC scans for primary prevention. The average age of the cohort was 54.4 years and majority of participants were male (67%) and White (89%). Over a median follow-up of 12.5 years, 260 HF-related deaths were recorded.

Over 75% of these deaths occurred in individuals with a baseline CAC score above 100, indicating a strong link between coronary calcium burden and future risk of heart failure death. Compared with individuals with a zero CAC score, those with scores of 1–100 had more than twice the risk of HF mortality [sub-distribution hazard ratio (SHR) 2.27]. 
The risk rose progressively with higher calcium scores. i.e., patients with CAC 100–400 had 3.7 times the risk, and those with scores above 400 had more than sevenfold increased risk (SHR 7.05). This stepwise pattern remained consistent regardless of age, sex, or calculated cardiovascular risk.