Coronary Artery Calcium Scoring for Risk Assessment in Patients With Severe Hypercholesterolemia
Section snippets
Methods
Patients were enrolled from the CLARIFY (Community Benefit of No-Charge Calcium Score Screening Program) study (ClinicalTrials.gov identifier: NCT04075162). The CLARIFY study enrolled 52,214 patients from 2014 to 2020, with at least 1 CV risk factor but without previous atherosclerotic CV disease, in a large health system (University Hospitals) in Cleveland, Ohio.8 CAC was offered at low charge ($99, January 2014 to December 2016) or no charge (January 2017 to current). All patients underwent
Results
Of the 52,214 patients included in the CLARIFY study, 1,904 participants (3.6%) had at least 1 measured LDL-C ≥190 mg/100 ml (1,257 women, 647 men, aged 57.8 ± 9.3 years). LDL-C ranged from 190 to 524 mg/100 ml (mean 215.5 ± 27 mg/100 ml). Overall, 864 patients (45.4%) had a CAC = 0 and 1,561 patients (82%) with CAC <100. Baseline characteristics for all patients, stratified by CAC category (0, 1 to 99, 100 to 399, 400+) are reported in Table 1. Prevalent CAC was associated with older age, male
Discussion
To the best of our knowledge, this is the largest study investigating the role of CAC in real-world cohort of patients with severe dyslipidemia. Our study demonstrates that CAC provides value in risk stratification for patients with severe hypercholesterolemia (LDL-C ≥190 mg/100 ml). CAC was linked with dose-response relation with statin prescription and cholesterol lowering in this cohort.
It was previously demonstrated that approximately 600,000 patients in the United States and between 14 and
Disclosures
The authors have no conflicts of interest to declare.
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Drs. Rajagopalan, and Al-Kindi contributed equally as co-senior authors.
Funding: None.