Coronary artery calcium scan most effective in predicting risk of heart disease: research
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 coronary artery calcium (CAC), uses a CT scan to detect calcium build-up in the arteries around the heart. The study findings are presented in the Aug. 22 issue of the Journal of the American Medical Association.
Current medical guidelines recommend classifying individuals as high, intermediate or low risk using the Framingham Risk Score (FRS), a cardiovascular risk-prediction 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 prevention interventions, 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-Ethnic Study of Atherosclerosis (MESA) study, the researchers did a head-to-head comparison of six top assessment tests for cardiovascular risk 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.
Journal reference: Journal of the American Medical Association
Provided by Wake Forest University Baptist Medical Center
- Adding coronary calcium score to traditional risk factors improves risk assessment for heart disease Apr 27, 2010 | not rated yet | 0
- Gene screening may refine prediction of heart attack risk, researchers say Nov 17, 2010 | not rated yet | 0
- Common test could help predict early death in diabetes, study shows May 23, 2011 | not rated yet | 0
- Low risk for heart attack? Could an ultrasound hold the answer? Nov 11, 2008 | not rated yet | 0
- Study finds coronary calcium beats C-reactive protein for predicting heart attack and stroke risk Aug 19, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
The idea behind a reverse shock
49 minutes ago So in a supernova explosion for example (5th slide) http://www.astro.princeton.edu/~burrows/classes/541/blastwavesChisari.pdf Ambient medium is...
Guass's Law for a charge distribution
1 hour ago First, this is not a homework question, just something I've been confused about for some time. I understand how to use Guass's law in many ways but...
1 hour ago Hello :) i'm new to this forum, so excuse me for my straightforwardness ;) I'm working on my bachelor work and i can't find a solution. I'm writing...
siphon and bernouli theorum
3 hours ago 1. I found this diagram on book but there weren't any description.can someone tell me, what its trying to tell specially by those two red lines...
Hot gas expansion rate into outer space
3 hours ago Good Morning Sirs, it seems to be surprisingly hard to get the numbers of a mystery: How fast expand hot rocket exhaust gases into empty space? ...
Magnetic field lines through copper
8 hours ago Hello. Assume an electron gun, as in CRT, made of plumbing copper instead of glass. Using magnetic scanning coils to move electron beam. Will the...
- More from Physics Forums - Classical Physics
More news stories
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
Cardiology 6 hours ago | not rated yet | 1
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
Cardiology 6 hours ago | not rated yet | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
Cardiology 6 hours ago | 5 / 5 (2) | 4
Transcatheter aortic valve implantation (TAVI) is effective and safe in Asian patients, according to early experience based on first results from a multicentre Asian registry reported at EuroPCR 2013.
Cardiology May 24, 2013 | not rated yet | 0
Routinely measuring fractional flow reserve (FFR) using pressure wire assessment during coronary angiography for diagnosis of chest pain leads to significant changes in the management of one in four patients, according to ...
Cardiology May 24, 2013 | not rated yet | 0
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
6 hours ago | not rated yet | 0
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
23 hours ago | 3 / 5 (2) | 0 |
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
22 hours ago | not rated yet | 0
Kate O'Reilly's spring allergy survival kit includes the usual stuff - nasal sprays, allergy pills and a box of tissues. This season, she's added a new weapon to her line of defense: an app on her smartphone.
23 hours ago | not rated yet | 0
(Medical Xpress)—A research team, led by Jeremy Barr, a biology post-doctoral fellow, unveils a new immune system that protects humans and animals from infection.
May 20, 2013 | 4.8 / 5 (30) | 9 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
May 24, 2013 | 4 / 5 (4) | 4 |