Filling the Evidence Gaps Toward a Coronary Artery Calcium-Guided Primary Prevention Strategy

“I think the adherence to medical therapy is what made it a positive study. Almost everyone stayed on medication after being shown their CT images, compared to the wider community where only 50% stay on statins in primary prevention at 12 months. I think the benefit of CAC is as much of an educational tool as it is as a guide for doctors to start preventive therapy. It moves the patient's perception from: 'I've got risk factors that could or could not be important in 20 years' time' to 'I have evidence of early coronary disease.'”

“As a preventive cardiologist, one of the biggest dilemmas that we have while managing patients is the question: what is your risk? That simple question demands a smarter answer. We have spent decades trying to estimate risk with risk scores, but why are we still guessing? [With] risk scores like the pooled cohort equations, the PREVENT score, and even the Australian risk scores, there is a growing realization that they are inherently imprecise. They don't detect disease. They just estimate probabilities.”