Abstract
Background
The latest AHA/ACC cholesterol guidelines on primary prevention of coronary artery disease (CAD) recommend the use of the CAC-score to help in decision making for not using or using statins: If the CAC-score is 0, it is reasonable to withhold statin therapy (as long as higher conditions are absent). If CAC-score is 1 - 99, it is reasonable to initate statin therapy for patients ≥55 years of age. If the CAC-score is ≥100, it is reasonable to initiate statin therapy. Therefore, in the present analysis, we assessed the impact of these guidelines in everyday cardiology practice.
Methods
We analysed our data base with 16083 assessments of the CAC-score in persons with no known coronary or other cardiovascular disease and no exercise-dependent chest pain or shortness of breath. The CAC-score was determined with a multi-slice CT. Using the “step-and-shoot” acquisition protocol, the average dose was around 1 mSv.
Results
In the total group, a CAC-score of 0 was found in 35%, a CAC-score of >0 up to <100 in 36% and ≥100 in 29%. The percentage of the above mentioned 3 CAC-score groups depending on age and gender are listed in table 1.
Conclusion
With the support of the CAC-score, a prescription of statins can be avoided in up to appr. 60% of middle-aged male and up to appr. 80% of middle-aged female persons. On the other hand, the use of statin is reasonable in appr. two thirds of higher-aged male and one third of higher-aged female persons for primary prevention.
Funding Acknowledgement
Type of funding source: None
ASSESSMENT OF CORONARY ATHEROSCLEROSIS PROGRESSION IN PATIENTS WITH FIVE YEAR HISTORY OF MYOCARDIAL INFARCTION DEPENDING ON THE STATIN THERAPY COMPLIANCE
