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According to a recent study, a patient's coronary calcium levels are better predictor of blocked coronary arteries at risk for a heart attack.
The study was presented at the American Heart Association Scientific Sessions 2018.
"With coronary calcium, we are looking at a marker indicating the presence of anatomical disease – we are not only at risk based on a patient's standard risk factors. t tell whether or not you actually have the disease, "said Jeffrey L. Anderson.
Cardiovascular disease remains the greatest cause of morbidity and mortality in the United States, and is estimated to be at highest risk to be suboptimal, said Dr. Anderson.
In the study, researchers at the Intermountain Medical Center Heart Institute identified 1,107 symptomatic patients who presented to the healthcare system with no known coronary artery disease and who had a PET-stress test to measure coronary flow, as part of their diagnostic evaluation.
The PET / CT test also enabled a coronary calcium score to be measured. Based on the coronary calcium and their cardiovascular disease risk factors were calculated: the standard Pooled Cohort Equation (based on traditional risk factors), the Multi-Ethnic Study of Atherosclerosis (MESA) Risk Score (which combines coronary calcium and traditional risk factors), and the Coronary Calcium Score alone.
Researchers tracked those patients to identify who, based on PET scan results suggested a blocked artery, went on to revascularization (a coronary stent or bypass surgery) and who had a subsequent heart attack or died during the subsequent two years.
They found that risk equations that included coronary artery calcium measurements, ie, the MESA Score and the Coronary Calcium Risk Score, were more likely to predict the presence of symptomatic coronary artery disease requiring revascularization than the Pooled Cohort Equation, which only relates to standard risk such factors as age, gender, blood pressure, and cholesterol measurements.
However, after the PET-scan results have been taken into account, all three equations were only moderately successful in determining who over two years of follow-up would go on to a heart attack. Noteworthy was that of the 29 patients who showed no coronary artery calcium, none of the major heart problems in the time-period tracked.
"Calcium in the artery does not tell you the extent of soft plaque, but it does not matter that it is present." These results tell us that coronary calcium adds significantly to estimated estimates, "Dr. Anderson said.
He also said the cost of coronary calcium screening is low, in the range of USD 100 or less, and should be considered in the future as part of routine medical care after age 50 for men and 55-60 for women.
"We accept that mammograms should be done for women and colonoscopies should be done at a certain age, and they are much more expensive than a calcium scan," he added.
Dr. Anderson hopes the findings lead to coronary calcium tests becoming more accepted and covered by medical insurance, which not only will get high-risk patients in treatment earlier, but also keeps patients who aren 't truly at risk from being overtreated.
(This story has been edited by Business Standard staff and is self-generated from a syndicated feed.)
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