CAC score may help regulate statins in patients with borderline ASCVD risk

Medically Reviewed By : Dr. Kamal Kant Kohli

Published On 2020-07-19 15:30 GMT | Update On 2020-07-19 15:31 GMT

USA: CAC score should be used in patients with borderline or intermediate ASCVD risk to assist in the decision of taking or withdrawing statin use for primary prevention of ASCVD, suggests a recent study in the journal Mayo Clinic Proceedings.

The decision about whether to recommend a statin for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) although is clear in patients with high ASCVD score, but whether to allot statins or not in patients with borderline or intermediate-risk has been a conundrum. Patient-specific treatment decisions are needed to provide maximal benefit and avoid unnecessary treatment.

Guideline-based lipid management proposes that coronary artery calcium (CAC) scoring is reasonable to implement in patients with a 10-year risk of 5.0% to 19.9% (borderline to intermediate risk) by using the pooled cohort equations when the decision about whether to initiate statin therapy is uncertain

Carl E. Orringer and Kevin C. Maki from the USA reported data from both observational studies and a large primary prevention randomized controlled trial that support the position that this decision is, in fact, uncertain in about half of such patients because of risk misclassification.

Key findings of the study include:

Such misclassification can be largely avoided by more widespread implementation of coronary calcium scoring, which helps to identify those with coronary artery calcium scores of 0, a finding associated with a less than 5.0% 10-year probability of an ASCVD event.
Deferral of statin therapy in such patients, in the absence of smoking, diabetes, or a family history of premature ASCVD, provides more individualized and appropriate care and avoids the expense and potential adverse effects of statin therapy in those with low potential for absolute risk reduction.
A rationale is also provided for the importance of coronary artery calcium scoring in women 50 years and older, possibly in place of 1 screening mammogram in women at least 55 years of age to avoid incremental radiation exposure, on the basis of the substantially higher lifetime risk of morbidity and mortality from ASCVD than from breast cancer.

"In patients with borderline or intermediate ASCVD risk, coronary artery calcium scoring should be used, whenever possible, as an aid to rational statin allocation for the primary prevention of ASCVD," concluded the authors.

The study, "HOPE for Rational Statin Allocation for Primary Prevention: A Coronary Artery Calcium Picture Is Worth 1000 Words," is published in the journal Mayo Clinic Proceedings.

DOI: https://doi.org/10.1016/j.mayocp.2020.01.016

Article Source : Mayo Clinic Proceedings

Disclaimer: This website is primarily for healthcare professionals. The content here does not replace medical advice and should not be used as medical, diagnostic, endorsement, treatment, or prescription advice. Medical science evolves rapidly, and we strive to keep our information current. If you find any discrepancies, please contact us at corrections@medicaldialogues.in. Read our Correction Policy here. Nothing here should be used as a substitute for medical advice, diagnosis, or treatment. We do not endorse any healthcare advice that contradicts a physician's guidance. Use of this site is subject to our Terms of Use, Privacy Policy, and Advertisement Policy. For more details, read our Full Disclaimer here.

NOTE: Join us in combating medical misinformation. If you encounter a questionable health, medical, or medical education claim, email us at factcheck@medicaldialogues.in for evaluation.

Medha Baranwal

Comments Policy

Our comments section is governed by our Comments Policy . By posting comments at Medical Dialogues you automatically agree with our Comments Policy , Terms And Conditions and Privacy Policy .

CAC score may help regulate statins in patients with borderline ASCVD risk

Similar News

Androgenic anabolic steroids exposure associated with coronary atherosclerosis and MI: JAMA

AI helped older adults report accurate blood pressure readings at home: Study

Digitoxin Reduces Mortality and Hospitalizations in Heart Failure with Reduced Ejection Fraction: NEJM

HEPA Filters Lower Blood Pressure in High-Pollution Areas: Study

Age-related Eye Diseases Increase Risk of Comorbid CHD and Depression, reveals study

Undiagnosed Sleep-Disordered Breathing Worsens Heart Function in HCM Patients: JAMA

Study Links Metabolic Syndrome to Adverse Coronary Plaque Profiles in T2DM

Cardiac MRI Workflow Improves Prediction of Sudden Cardiac Death in Dilated Cardiomyopathy: Study Shows