Heart calcium scans are far superior to other assessment tools in predicting the development of cardiovascular disease in individuals currently classified at intermediate risk by their doctors, according to researchers at Wake Forest Baptist Medical Center.
The test, known as coronary artery calcium (CAC), uses a CT scan to detect calcium build-up in the arteries around the heart. The study findings are presented in the Aug. 22 issue of the Journal of the American Medical Association.
Current medical guidelines recommend classifying individuals as high, intermediate or low risk using the Framingham Risk Score (FRS), a cardiovascular risk-prediction model. However, doctors realize that the model isn't perfect and that the intermediate group actually includes some individuals who could benefit from more aggressive drug therapy, as well as individuals who could be managed solely with lifestyle measures.
"We know how to treat patients at low and high risk for heart disease, but for the estimated 23 million Americans who are at intermediate risk, we still are not certain about the best way to proceed," said Joseph Yeboah, M.D., assistant professor of cardiology at Wake Forest Baptist and lead author of the study.
The Wake Forest Baptist study, which was funded by the National Heart Lung and Blood Institute (NHLBI) of the National Institutes of Health, evaluated which of the top-tier assessment tools best identified people within the intermediate group who were actually at higher or lower risk. Determining the relative improvements in prediction afforded by various tests, especially when used in conjunction with the FRS, could help identify intermediate-risk people who may benefit from more aggressive primary prevention interventions, including the use of aspirin and the setting of lower targets for drug treatment of LDL cholesterol and blood pressure, Yeboah said.