Why the study?
To establish tailored preventive treatment, the study evaluated the ability of coronary artery calcium scoring to reclassify intermediate cardiovascular risk patients and examined its association with additional risk factors in a Mexican preventive care center.
Does coronary artery calcium scoring improve cardiovascular risk reclassification compared to traditional risk scores in asymptomatic Mexican patients?
Does coronary artery calcium scoring improve cardiovascular risk reclassification compared to traditional risk scores in asymptomatic Mexican patients?
Coronary artery calcium scoring frequently reclassifies cardiovascular risk in asymptomatic Mexican patients, potentially optimizing statin therapy allocation.
May aid reclassification of intermediate-risk Mexicans; extends CAC data to this population but leaves outcome and therapy effects open.
Objectives: To establish tailored preventive treatment, we studied the ability of coronary artery calcium scoring to reclassify patients with intermediate cardiovascular risk and its association with additional risk factors in our Mexican preventive care center. Materials and methods: In this retrospective cohort study, we analyzed 520 asymptomatic patients from a Mexican primary prevention population between 2014 and 2018. Coronary artery calcium scoring, laboratory results, and anthropometric measurements (abdominal circumference and body mass index) were assessed. The Framingham risk score and American Heart Association/American College of Cardiology (AHA/ACC) atherosclerotic cardiovascular disease risk algorithm were calculated. Correlations between coronary artery calcium scoring, anthropometric measurements, and clinical cardiovascular risk scores were assessed. We assessed the ability of coronary artery calcium scoring to reclassify patients recommended for statin therapy compared with the cardiovascular risk scores. Results: Patients had a mean age of 67.5 years ( SD ± 9.8) and 294 subjects (56.5%) were male. Coronary artery calcium scoring has a positive correlation with age, AHA/ACC atherosclerotic cardiovascular disease risk algorithm, and Framingham risk score ( p < 0.001 for all). Coronary artery calcium scoring was prevalent, occurring in 63.2% of patients with a median Agatston score of 22 with and interquartile range of 178. Male gender, older age, smoking habit, diabetes, and abdominal circumference were independent predictors of coronary artery calcium scoring ( p < 0.001). Coronary artery calcium scoring downwardly reclassified 44.9% of patients in intermediate cardiovascular risk categories by the AHA/ACC atherosclerotic cardiovascular disease risk algorithm and 43.9% by the Framingham risk score. Coronary artery calcium scoring upwardly reclassified 46.8% of patients in intermediate risk categories by the AHA/ACC atherosclerotic cardiovascular disease risk algorithm and 56% by the Framingham risk score. Conclusion: Coronary artery calcium scoring is prevalent in this Mexican primary prevention cohort and has the ability to reclassify a significant percentage of intermediate cardiovascular risk patients.
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Mézquita et al. (2020) studied this question.
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