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Impact of coronary artery calcium testing on patient management.
Wu, Wanda Y; Biery, David W; Berman, Adam N; Hsieh, Grace; Divakaran, Sanjay; Gupta, Sumit; Steigner, Michael L; Aghayev, Ayaz; Skali, Hicham; Polk, Donna M; Plutzky, Jorge; Cannon, Christopher P; Di Carli, Marcelo F; Blankstein, Ron.
Afiliación
  • Wu WY; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA.
  • Biery DW; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Berman AN; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Hsieh G; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Divakaran S; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Gupta S; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Steigner ML; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Aghayev A; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Skali H; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Polk DM; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Plutzky J; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Cannon CP; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Di Carli MF; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Blankstein R; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: rblankstein@bwh.harvard.edu.
J Cardiovasc Comput Tomogr ; 16(4): 303-308, 2022.
Article en 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€‹= â€‹0, 289 (34%) had CAC â€‹= â€‹1-99, and 174 (21%) had CAC≥100. The mean age at time of CAC testing was 59 â€‹± â€‹9.7 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€‹< â€‹0.001), anti-hypertensives (9% increase, p â€‹= â€‹0.031), and lipid-lowering therapies (114% increase, p â€‹< â€‹0.001), whereas CAC â€‹= â€‹0 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€‹= â€‹0.008) and exercise (p â€‹= â€‹0.004). 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Calcificación Vascular Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: J Cardiovasc Comput Tomogr Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / RADIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Calcificación Vascular Tipo de estudio: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male Idioma: En Revista: J Cardiovasc Comput Tomogr Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / RADIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos