Relation of Absence of Coronary Artery Calcium to Cardiovascular Disease Mortality Risk Among Individuals Meeting Criteria for Statin Therapy According to the 2018/2019 ACC/AHA Guidelines
Section snippets
Methods
CAC Consortium represents four participating institutions from three states within the US (California, Minnesota, and Ohio), which contributed data from 66,636 asymptomatic patients spanning years 1991 to 2010.7 This is an observational retrospective cohort study designed primarily to evaluate the association between CAC and long-term mortality. All CAC scans were clinically indicated and physician-referred in patients without a known history of coronary heart disease (CHD). Further details on
Results
The study cohort consisted of 13,972 asymptomatic patients without known CHD. Patient selection for the present analysis was determined according to the 2018/2019 ACC/AHA guidelines and is depicted in Figure 1. Of 13,972 participants, 3,853 on lipid-lowering medication at the time of baseline CAC scanning were excluded from the present analysis. Of the resulting 10,119 participants, 3,257 missing LDL-C levels were excluded from the analysis. Additional exclusions included participants with
Discussion
Our study demonstrates that CAC scoring substantially differentiates the risk for all-cause and CVD-specific mortality in patients with and without statin recommendation for primary prevention according to the 2018/2019 ACC/AHA guidelines. Overall, in a large cohort of asymptomatic patients who underwent CAC scanning for the evaluation of subclinical atherosclerosis, the all-cause, and CVD-specific mortality rates were much higher in the statin recommended population compared with the
Declaration of Competing Interest
The authors report no conflicts of interest to disclose relevant to the content of this manuscript.
Author contribution
Tanuja Rajan: Conceptualization, data curation, formal analysis, investigation, methodology, visualization, validation, interpretation of data, writing – original draft, Writing- review and editing. Alan Rozanski: Conceptualization, data curation, formal analysis, investigation, methodology, visualization, validation, interpretation of data, writing – original draft, Writing- review and editing, Supervision. Miguel Cainzos-Achirica: Writing – original draft, writing- review and editing. Gowtham
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Tanuja Rajan and Alan Rozanski contributed equally to this work as co-first authors
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