Feature | December 26, 2013

Study Shows Value of Calcium Scan in Predicting Heart Attack, Stroke Among Those Considered Low or High Risk

Low or high risk coronary artery calcium testing trumps cholesterol levels, high blood pressure, other risk factors in predicting heart attacks, deaths

December 26, 2013 — A study shows that coronary artery calcium (CAC) screening, an assessment tool that is not currently recommended for people considered at low risk, should play a more prominent role in helping determine a person’s risk for heart attack and heart disease-related death, as well as the need for angioplasty or bypass surgery. CAC screening provides a direct measure of calcium deposits in heart arteries and is easily obtained on a computed tomography (CT) scan.
 
“We showed that by using only the traditional risk factors, we miss a significant percentage of individuals at high risk. We may also be over-treating a large number of people who can safely avoid lifelong treatment,” said lead author Michael Silverman, M.D., cardiology fellow, Brigham and Women’s Hospital, Boston, and lead author. Silverman formerly worked at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore.
 
In the study published online Dec. 23 in the European Heart Journal, the researchers compared two approaches to risk assessment. One approach looked only at risk factors including cholesterol, blood pressure, current smoking and diabetes. The other used the direct measurement of atherosclerosis as seen on the coronary artery calcium score.
 
“Our study, using data from almost 7,000 adult participants in the Multi-Ethnic Study of Atherosclerosis (MESA), shows that coronary artery calcium screening provides an accurate, personalized assessment for those who, by traditional risk factors, are at either high or low risk of a heart attack or death from coronary artery disease,” said Khurram Nasir, M.D., M.P.H, director, wellness and prevention research, Baptist Health Medical Group, Miami, and senior author of the study. Nasir is also an adjunct faculty member at the Johns Hopkins University School of Medicine.
 
The MESA participants did not have evidence of heart disease when they joined the study between 2000 and 2002. They were assessed for risk factors and had a coronary calcium scan and were followed for a mean of 7.1 years for coronary heart disease events, such as heart attacks.
 
“We found that 15 percent of people believed to be at very low risk actually had high coronary artery calcium scores above 100 and were at relatively high risk of a cardiac event over the next seven years,” said Roger Blumenthal, M.D., professor of medicine, director, Johns Hopkins Ciccarone Center, and co-author of the study. “On the other hand, 35 percent of study participants thought to be at very high risk and needing aggressive therapy with aspirin and statin medication actually had no coronary artery calcium and an extremely low event rate of the next seven years. For them, we can emphasize lifestyle modifications.”
 
According to Nasir, the results may encourage a major paradigm shift in how physicians estimate heart disease risk for their patients. 
 
“Our study shows that coronary artery calcium testing holds promise as a frontline assessment for people before they develop heart disease symptoms. In the meantime, we believe that doctors should consider offering a coronary artery calcium scan to their patients to markedly improve risk prediction if they are unsure whether they should be on lifelong statin and aspirin therapy.”
 
The study, “Impact of Coronary Artery Calcium on Coronary Heart Disease Events in Individuals at the Extremes of Traditional Risk Factor Burden: The Multi-Ethnic Study of Atherosclerosis,” was supported by the National Institutes of Health grant numbers N01-HC-95159 to N01-HC-95166, N01 HC 95169, U01HL105270-03 to HMK and T32-HL-7227-36 to MGS.
 
For more information: baptisthealth.com, www.hopkinsmedicine.org, eurheartj.oxfordjournals.org

Related Content

A key slide from Elnabawi's presentation, showing cardiac CT plaque evaluations, showing the impact of psoriasis medication on coronary plaques at baseline and one year of treatment. It shows a reversal of vulnerable plaque development. #SCAI, #SCAI2018

A key slide from Elnabawi's presentation, showing cardiac CT plaque evaluations, showing the impact of psoriasis medication on coronary plaques at baseline and one year of treatment. It shows a reversal of vulnerable plaque development.  

Feature | Cardiovascular Clinical Studies | May 14, 2018
May 14, 2018 – New clinical evidance shows common therapy options for psoriasis (PSO), a chronic inflammatory skin di
Intravenous Drug Use is Causing Rise in Heart Valve Infections, Healthcare Costs. #SCAI, #SCAI2018
News | Cardiovascular Clinical Studies | May 14, 2018
May 14, 2018 — The opioid drug epidemic is impacting cardiology, with a new study finding the number of patients hosp
Patient Enrollment Completed in U.S. IDE Study of THERMOCOOL SMARTTOUCH SF Catheter
News | Cardiovascular Clinical Studies | March 15, 2018
March 15, 2018 –  Johnson & Johnson Medical Devices Companies announced today that Biosense Webster, Inc., who wo
Lexington Begins HeartSentry Clinical Trial
News | Cardiovascular Clinical Studies | February 20, 2018
February 20, 2018 – Lexington Biosciences, Inc., a development-stage medical device company, announced the commenceme
Endologix Completes Patient Enrollment in the ELEVATE IDE Clinical Study
News | Cardiovascular Clinical Studies | February 06, 2018
February 6, 2018 – Endologix, a developer and marketer of treatments for aortic disorders, announced the completion o
12-Month Results from Veryan Medical's MIMICS-2 IDE Study Presented at LINC
News | Cardiovascular Clinical Studies | February 01, 2018
February 1, 2018 – Thomas Zeller (Bad Krozingen, Germany) presented the 12-month results from Veryan Medical’s MIMICS
LimFlow Completes U.S. Feasibility Study Enrollment, Receives FDA Device Status
News | Cardiovascular Clinical Studies | February 01, 2018
February 1, 2018 –  LimFlow SA, developer of minimally-inv
ESC 2017 late breaking trial hot line study presentations.
News | Cardiovascular Clinical Studies | September 12, 2017
September 12, 2017 – The European Society of Cardiology (ESC) Congress 2017 includes several Hot Line Late-breaking C
U.K., NHS studies, weekend effect, hospital admission, atrial fibrillation, heart failure
News | Cardiovascular Clinical Studies | June 28, 2016
New research shows patients admitted to National Health Service (NHS) hospitals in the United Kingdom for atrial...
stroke risk
News | Cardiovascular Clinical Studies | August 28, 2015
Most people assume strokes only happen to octogenarians, but recent evidence suggests that survivors of childhood can
Overlay Init