Coronary Artery Calcium Scoring (CACS) can be used to predict the likelihood of future cardiovascular events.\u00a0 However, whether this provides extra information on top of traditional cardiovascular risk factors remains unclear.
\nIn this study 6814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) underwent CACS and were then followed up for five year.\u00a0 None of the participants were known to have cardiovascular disease, but patients with diabetes were excluded from the primary analysis.\u00a0 The authors used two predictive models; the first contained the traditional cardiovascular risk factors of age, sex, tobacco use, systolic blood pressure, antihypertensive use, total and HDL cholesterol and race\/ethnicity.\u00a0 The second used all of these factors and in addition CACS.\u00a0 The authors calculated the net reclassification improvement and compared the distribution of risk using both models.
\nMedian follow-up was 5.8 years, during which 209 coronary heart disease (CHD) events occurred, of which were 122 myocardial infarctions, death from CHD, or resuscitated cardiac arrest.\u00a0 The use of CACS resulted in significant improvements in risk prediction compared to the use of traditional risk factors alone (net reclassification benefit 0.25, 95% CI 0.16-0.34; p<0.001).\u00a0 A larger number of patients were classified either in the very high risk or the very low risk category using CACS (77% vs 69%).\u00a0 Of note, 23% of patients who experienced events were reclassified as high risk when CACS was used, and 13% of patients without an event were reclassified as low risk using CACS.<\/p>\n
Conclusion:<\/p>\n
The use of CACS in a cardiovascular risk prediction model significantly improved the classification of risk, and placed more individuals in the high and low risk categories.\u00a0 However, whether this can be used to improve patient outcomes remains to be proven.<\/p>\n
\u2022\u00a0Polonsky TS, McClelland RL, Jorgensen NW et al.\u00a0 Coronary Artery Calcium Score and Risk Classification for Coronary Heart Disease Prediction.\u00a0 JAMA 2010;303(16):1610-1616<\/p>\n","protected":false},"excerpt":{"rendered":"
Coronary Artery Calcium Scoring (CACS) can be used to predict the likelihood of future cardiovascular events.\u00a0 However, whether this provides extra information on top of traditional cardiovascular risk factors remains unclear. In this study 6814 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) underwent CACS and were then followed up for five year.\u00a0 None of […]<\/p>\n