Score de cálcio coronário e reclassificação do risco cardiovascular em doentes submetidos a angiografia coronária por tomografia computadorizada

Translated title of the contribution: Coronary artery calcium scoring and cardiovascular risk reclassification in patients undergoing coronary computed tomography angiography

Daniel Matos, António Miguel Ferreira*, Pedro de Araújo Gonçalves, Francisco Gama, Pedro Freitas, Sara Guerreiro, Gonçalo Cardoso, António Tralhão, Hélder Dores, João Abecasis, Hugo Marques, Carla Saraiva, Miguel Mendes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

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.

Translated title of the contributionCoronary artery calcium scoring and cardiovascular risk reclassification in patients undergoing coronary computed tomography angiography
Original languagePortuguese
Pages (from-to)25-30
Number of pages6
JournalRevista Portuguesa de Cardiologia
Volume40
Issue number1
DOIs
Publication statusPublished - Jan 2021
Externally publishedYes

Keywords

  • Antiplatelet therapy
  • Cardiovascular risk stratification
  • Coronary artery calcium score
  • Coronary computed tomography angiography
  • MESA risk score

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