TY - JOUR
T1 - Score de cálcio coronário e reclassificação do risco cardiovascular em doentes submetidos a angiografia coronária por tomografia computadorizada
AU - Matos, Daniel
AU - Ferreira, António Miguel
AU - Gonçalves, Pedro de Araújo
AU - Gama, Francisco
AU - Freitas, Pedro
AU - Guerreiro, Sara
AU - Cardoso, Gonçalo
AU - Tralhão, António
AU - Dores, Hélder
AU - Abecasis, João
AU - Marques, Hugo
AU - Saraiva, Carla
AU - Mendes, Miguel
N1 - Publisher Copyright:
© 2020 Sociedade Portuguesa de Cardiologia
PY - 2021/1
Y1 - 2021/1
N2 - Introduction: Coronary artery calcium (CAC) scoring is used for both cardiovascular risk reclassification and as a gatekeeper for coronary computed tomography angiography (CCTA). The aims of this study were to assess to what extent CAC score results can reclassify the cardiovascular risk of patients without obstructive coronary artery disease (CAD) on CCTA, and to measure the proportion of these patients whose primary prevention medication is changed after the exam. Methods: In a retrospective analysis of a multicenter registry of individuals who underwent CCTA for suspected CAD during a two-year period, the Systematic COronary Risk Evaluation (SCORE) and Multi-Ethnic Study of Atherosclerosis (MESA) risk scores were calculated for each individual. In a subset of 184 patients, we also assessed the prescription of statins and antiplatelet agents before and after the test. Results: A total of 467 patients (248 women, mean age 60±9.10 years) were included. Median CAC score was 0 (interquartile range 0-40). Overall, 249 patients (53%) and 159 (34%) were classified as being of moderate/intermediate risk according to the SCORE and MESA risk scores, respectively. Among these, 29 (12%) and 30 (19%) patients had CAC score >100 AU, making them eligible for statin therapy. The inclusion of CAC scoring in the MESA score resulted in the reclassification of 215 patients (46%). The proportion of patients who were prescribed statins or antiplatelet agents did not change significantly after the test. Conclusion: CAC scoring can reclassify cardiovascular risk in a significant proportion of patients undergoing CCTA. Despite this, little change was seen in the prescription of statins and antiplatelet agents.
AB - Introduction: Coronary artery calcium (CAC) scoring is used for both cardiovascular risk reclassification and as a gatekeeper for coronary computed tomography angiography (CCTA). The aims of this study were to assess to what extent CAC score results can reclassify the cardiovascular risk of patients without obstructive coronary artery disease (CAD) on CCTA, and to measure the proportion of these patients whose primary prevention medication is changed after the exam. Methods: In a retrospective analysis of a multicenter registry of individuals who underwent CCTA for suspected CAD during a two-year period, the Systematic COronary Risk Evaluation (SCORE) and Multi-Ethnic Study of Atherosclerosis (MESA) risk scores were calculated for each individual. In a subset of 184 patients, we also assessed the prescription of statins and antiplatelet agents before and after the test. Results: A total of 467 patients (248 women, mean age 60±9.10 years) were included. Median CAC score was 0 (interquartile range 0-40). Overall, 249 patients (53%) and 159 (34%) were classified as being of moderate/intermediate risk according to the SCORE and MESA risk scores, respectively. Among these, 29 (12%) and 30 (19%) patients had CAC score >100 AU, making them eligible for statin therapy. The inclusion of CAC scoring in the MESA score resulted in the reclassification of 215 patients (46%). The proportion of patients who were prescribed statins or antiplatelet agents did not change significantly after the test. Conclusion: CAC scoring can reclassify cardiovascular risk in a significant proportion of patients undergoing CCTA. Despite this, little change was seen in the prescription of statins and antiplatelet agents.
KW - Antiplatelet therapy
KW - Cardiovascular risk stratification
KW - Coronary artery calcium score
KW - Coronary computed tomography angiography
KW - MESA risk score
KW - Antiplatelet therapy
KW - Cardiovascular risk stratification
KW - Coronary artery calcium score
KW - Coronary computed tomography angiography
KW - MESA risk score
UR - http://www.scopus.com/inward/record.url?scp=85097474177&partnerID=8YFLogxK
U2 - 10.1016/j.repc.2020.04.011
DO - 10.1016/j.repc.2020.04.011
M3 - Article
C2 - 33303300
AN - SCOPUS:85097474177
SN - 0870-2551
VL - 40
SP - 25
EP - 30
JO - Revista Portuguesa de Cardiologia
JF - Revista Portuguesa de Cardiologia
IS - 1
ER -