Coronary artery calcium scan most effective in predicting risk of heart disease: research

August 21, 2012 in Cardiology

Heart calcium scans are far superior to other assessment tools in predicting the development of cardiovascular disease in individuals currently classified at intermediate risk by their doctors, according to researchers at Wake Forest Baptist Medical Center.

The test, known as (CAC), uses a to detect calcium build-up in the arteries around the heart. The study findings are presented in the Aug. 22 issue of the .

Current recommend classifying individuals as high, intermediate or low risk using the Framingham Risk Score (FRS), a cardiovascular model. However, doctors realize that the model isn't perfect and that the intermediate group actually includes some individuals who could benefit from more aggressive drug therapy, as well as individuals who could be managed solely with lifestyle measures.

"We know how to treat patients at low and high risk for heart disease, but for the estimated 23 million Americans who are at intermediate risk, we still are not certain about the best way to proceed," said Joseph Yeboah, M.D., assistant professor of cardiology at Wake Forest Baptist and lead author of the study.

The Wake Forest Baptist study, which was funded by the National Heart Lung and Blood Institute (NHLBI) of the National Institutes of Health, evaluated which of the top-tier assessment tools best identified people within the intermediate group who were actually at higher or lower risk. Determining the relative improvements in prediction afforded by various tests, especially when used in conjunction with the FRS, could help identify intermediate-risk people who may benefit from more aggressive primary , including the use of aspirin and the setting of lower targets for drug treatment of LDL cholesterol and blood pressure, Yeboah said.

Using data from the NHLBI's Multi- of Atherosclerosis (MESA) study, the researchers did a head-to-head comparison of six top assessment tests for prediction in intermediate-risk people: CAC score, ankle-brachial index, brachial flow mediated dilation, carotid intima-media thickness, high sensitivity C-reactive protein and family history of heart disease.

Of the 6,814 total MESA participants from six communities across the country, 1,330 were considered at intermediate risk and were included in this study. The researchers determined that the CAC score proved the best in predicting which among the intermediate-risk people would go on to have heart disease in the ensuing 7.5 years (average) of follow-up observation.

"If we want to concentrate our attention on the subset of intermediate-risk patients who are at the highest risk for cardiovascular disease, CAC is clearly the best tool we have in our arsenal to identify them. However, we have to look at other factors such as costs and risks associated with radiation exposure from a CT scan before deciding if everyone in the intermediate group should be screened," Yeboah said.

Additional research is needed to explore the costs, benefits and risks of widespread use of CAC screening in people at risk of heart disease, he said.

More information:
JAMA. 2012;308[8]:788-795.
JAMA. 2012;308[8]:816-817.

Journal reference: Journal of the American Medical Association search and more info website

Provided by Wake Forest University Baptist Medical Center search and more info website

not rated yet  

Rank not rated yet
Relevant PhysicsForums posts

More news stories

Free fatty acids linked to cardiac risk in late adulthood

(HealthDay)—Blood levels of free fatty acids are associated with insulin resistance during young adulthood and cardiovascular risk factors in later adulthood, according to a study published online May 13 ...

Cardiology created May 17, 2013 | popularity not rated yet | comments 0 | with audio podcast

Diagnosing heart attacks: There's an app for that

An experimental, inexpensive iPhone application transmitted diagnostic heart images faster and more reliably than emailing photo images, according to a research study presented at the American Heart Association's Quality ...

Cardiology created May 17, 2013 | popularity not rated yet | comments 0

Study suggests new role for ECMO in treating patients with cardiac arrest and profound shock

Extracorporeal membrane oxygenation (ECMO), a procedure traditionally used during cardiac surgeries and in the ICU that functions as an artificial replacement for a patient's heart and lungs, has also been used to resuscitate ...

Cardiology created May 17, 2013 | popularity not rated yet | comments 0

Stroke patients respond similarly to after-stroke care, despite age difference

Age has little to do with how patients should be treated after suffering a stroke, according to new research from the University of Georgia.

Cardiology created May 17, 2013 | popularity not rated yet | comments 0 | with audio podcast

Depression linked to almost doubled stroke risk in middle-aged women

Depressed middle-aged women have almost double the risk of having a stroke, according to research published in Stroke: Journal of the American Heart Association.

Cardiology created May 16, 2013 | popularity not rated yet | comments 0


Ketamine shows significant therapeutic benefit in people with treatment-resistant depression

Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the ...

Consuming coffee linked to lower risk of detrimental liver disease, study finds

Regular consumption of coffee is associated with a reduced risk of primary sclerosing cholangitis (PSC), an autoimmune liver disease, Mayo Clinic research shows. The findings were being presented at the Digestive Disease ...

Research examines new methods for managing digestive health

Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.

New smartphone application improves colonoscopy preparation

The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...

New research identifies practice changes to improve value and quality of GI procedures

There are significant cost and risk factors associated with two procedures commonly used to diagnose or treat gastrointestinal problems, according to research presented at Digestive Disease Week (DDW).

New research identifies risks, interventions for children's GI health

An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).