Integrating Coronary Artery Calcium Scoring Into Cardiovascular Prevention in Australia

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Imaging

Background:

• Coronary artery disease (CAD) is a leading cause of mortality in Australia.
• Existing risk prediction models frequently misclassify patient cardiovascular risk.
• Coronary artery calcium (CAC) scoring is a robust predictor of future cardiovascular events, particularly in asymptomatic individuals.

Purpose of the Study:

• To evaluate the role and potential integration of Coronary Artery Calcium (CAC) scoring into Australian cardiovascular disease prevention strategies.
• To address barriers hindering the wider adoption of CAC scoring in Australia.

Main Methods:

• Review of current international guidelines and practices for CAC scoring.
• Analysis of factors influencing CAC scoring uptake in Australia, including reimbursement and access.
• Consideration of specific population needs, such as Aboriginal and Torres Strait Islander peoples.

Main Results:

• CAC scoring is an established, reproducible measure of subclinical atherosclerosis and a strong predictor of cardiovascular events.
• Barriers to CAC scoring in Australia include lack of public reimbursement, conditional guidelines, and access issues, particularly for Indigenous populations.
• International evidence supports the utility of CAC scoring in risk stratification.

Conclusions:

• Integrating CAC scoring into national prevention strategies could improve the precision and cost-effectiveness of cardiovascular disease prevention in Australia.
• Subsidising CAC scans for appropriate patients and supporting general practitioner utilisation are key recommendations.
• Addressing access disparities is crucial for equitable implementation, especially for Aboriginal and Torres Strait Islander peoples.