Impact of coronary artery calcium testing on patient management.
J Cardiovasc Comput Tomogr
; 16(4): 303-308, 2022.
Article
in En
| MEDLINE
| ID: mdl-34998708
ABSTRACT
BACKGROUND:
Coronary artery calcium (CAC) scoring can identify individuals who may benefit from aggressive prevention therapies. However, there is a paucity of contemporary data on the impact of CAC testing on patient management.METHODS:
Retrospective cohort study of adults who underwent CAC testing at Brigham and Women's Hospital between 2015 and 2019. Information on baseline medications, follow-up medications, lifestyle modification, and downstream cardiovascular testing within one-year post-CAC were obtained from electronic health records.RESULTS:
Of the 839 patients with available baseline and follow-up data, 376 (45%) had a CAC â= â0, 289 (34%) had CAC â= â1-99, and 174 (21%) had CAC≥100. The mean age at time of CAC testing was 59 â± â9.7 years. Patients with higher CAC scores were more likely to be male, have diabetes and hypertension, and have higher low-density lipoprotein cholesterol and lower high-density lipoprotein cholesterol. A non-zero CAC score was associated with initiation of aspirin (41% increase, p â< â0.001), anti-hypertensives (9% increase, p â= â0.031), and lipid-lowering therapies (114% increase, p â< â0.001), whereas CAC â= â0 was not. Among individuals with CAC≥100, 75% were started on new or more intense lipid-lowering therapy. Higher calcium scores correlated with increased physician recommendations for diet (p â= â0.008) and exercise (p â= â0.004). The proportion of cardiovascular downstream testing following CAC was 9.1%, and the majority of patients who underwent additional testing post-CAC had CAC scores ≥100.CONCLUSION:
Approximately half of individuals referred for CAC testing had evidence of calcified coronary plaque, and of those who had significant calcifications (CAC≥100), nearly 90% were prescribed lipid-lowering therapies post-CAC. Rates of downstream non-invasive testing were low and such testing was mostly performed in patients who had at least moderate CAC.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Vascular Calcification
Type of study:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
J Cardiovasc Comput Tomogr
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
/
RADIOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
United States