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The Utility and Clinical Implications of Calcium Score Measurement: Experience of a Lipids Clinic
Ronit Lev Kolnik1, Idan Bergman1, Avishay Elis2
1Department of Internal Medicine C, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
Insights
Coronary artery calcium (CAC) scoring helps assess cardiovascular disease risk, guiding personalized treatment. Higher CAC scores correlate with increased lipid-lowering therapy prescriptions, with male sex and older age predicting elevated scores.
Area of Science:
- Cardiology
- Preventive Medicine
- Medical Imaging
Background:
- Coronary artery calcium (CAC) scoring is a key tool for cardiovascular disease risk assessment.
- It aids in personalized management strategies for primary prevention of atherosclerotic cardiovascular disease.
Purpose of the Study:
- To evaluate the clinical utility of CAC testing in real-world settings.
- To characterize indications for CAC scoring, the clinical significance of various scores, and associated lipid-lowering treatments.
Main Methods:
- Retrospective study of 88 patients at a lipid clinic (2017-2022).
- Data included demographics, comorbidities, CAC score indications, levels, and treatment regimens.
- Analysis focused on the relationship between CAC scores and therapeutic interventions.
Main Results:
- Primary indication for CAC testing was to assess atherosclerosis in patients without clear lipid-lowering treatment guidelines (74%).
- Most patients had no (30) or mild (35) atherosclerosis (CAC 0-99 AU).
- Lipid-lowering treatment prescription increased with CAC score, nearing 100% for scores ≥ 400 AU. Male sex and older age predicted CAC > 0 AU.
Conclusions:
- CAC scoring should be more widely adopted for cardiovascular risk assessment.
- Further research is needed to clarify the implications of CAC scores between 0-400 AU.
Background:
The Agatston coronary artery calcium (CAC) score is a decision-guiding aid for risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease.
Objectives:
To explore the real-life clinical experience of CAC testing by characterizing its indications, significance of scores, and corresponding lipid-lowering treatments.
Methods:
A retrospective descriptive study of patients treated at the lipids clinic at Rabin Medical Center (Beilinson Campus), who underwent CAC score evaluation between 2017 and 2022 was conducted. The data collected from electronic medical files included demographics, co-morbidities, indications for the test, CAC score levels, and the recommended therapeutic regimen.
Results:
The study cohort included 88 patients. The main indication was assessment of the existence of atherosclerosis in cases where there was no clear indication for lipid lowering treatment (65, 74%). In most patients, there was no evidence of atherosclerosis (CAC = 0 AU, n=30) or only mild disease (CAC=1-99 AU, n=35). As the CAC score increased, more patients were prescribed lipid lowering treatments, from very few prescriptions in those with a CAC score of 0 AU and almost 100% among those with score of ≥ 400 AU. The factors that predicted CAC > 0 AU were male sex and older age.
Conclusions:
CAC scores should be used more often to determine risk assessment. Further analysis of the implications of scores between 0-400 AU is needed.
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