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Coronary artery calcium scoring in cardiovascular risk assessment of people with family histories of early onset coronary artery disease
Venkataraman, P and Stanton, T and Liew, D and Huynh, Q and Nicholls, S and Mitchell, GK and Watts, GF and Tonkin, AM and Marwick, TH, Coronary artery calcium scoring in cardiovascular risk assessment of people with family histories of early onset coronary artery disease, Medical Journal of Australia pp. 1-8. ISSN 0025-729X (2020) [Refereed Article]
© 2020 AMPCo Pty Ltd
Design, setting, participants: People without known CAD were recruited at seven Australian hospitals, October 2016 - January 2019. Participants were aged 40-70 years, had a family history of early onset CAD, and a 5-year ACVDR of 2-15%.
Main outcome measures: CT coronary artery calcium score greater than zero (any coronary calcification) or greater than 100 (calcification warranting lipid therapy).
Results: 1059 participants were recruited; 477 (45%) had non-zero coronary artery calcium scores (median 5-year ACVDR, 4.8% [IQR, 2.9-7.6%]; median coronary artery calcium score, 41.7 [IQR, 8-124]); 582 (55%) did not (median 5-year ACVDR, 3.2% [IQR, 2.0-4.6%]). Of 151 participants with calcium scores of 100 or more, 116 (77%) were deemed to be at low cardiovascular risk by Australian guidelines, while 14 of 75 participants at intermediate risk (19%) had zero calcium scores. The sensitivity of the ACVDR calculator for identifying people with non-zero calcium scores (area under receiver operator curve [AUC], 0.674) was lower than that of the pooled cohort equation (AUC, 0.711; P < 0.001). ACVDR (10-year)- and Multi-Ethnic Study of Atherosclerosis (MESA)-predicted risk categories concurred for 511 participants (48%); classifications were concordant for 925 participants (87%) when the ACVDR was supplemented by calcium scores.
Conclusions: Coronary artery calcium scoring should be considered as part of the heart health check for patients at intermediate ACVDR risk and with family histories of early onset CAD. Alternative risk calculators may better select such patients for further diagnostic testing and primary prevention therapy.
|Item Type:||Refereed Article|
|Keywords:||calcium metabolism, cardiovascular risk factors, computed tomography, coronary artery disease, risk assessment|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Huynh, Q (Dr Quan Huynh)|
|Web of Science® Times Cited:||11|
|Deposited By:||Menzies Institute for Medical Research|
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