Impact of a cardiovascular disease risk screening result on preventive behaviour in asymptomatic participants of the ROBINSCA trial

Denissen, Sabine J A M; Aalst, Carlijn M. van der; Vonder, Marleen; Oudkerk, Matthijs; Koning, Harry J. de

doi:10.1177/2047487319843396

Cited by 27 publications

(26 citation statements)

References 24 publications

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“…Our results suggest that receiving a result based on actual atherosclerosis as a complement to conventional risk factor assessment and information could be more informative and can enhance CVD preventive actions. This finding is in line with another study using coronary calcium scoring to demonstrate subclinical atherosclerosis [ 16 ]. When patients with a high risk of CVD were interviewed about their experience of lifestyle change after participating in a lifestyle program, increased knowledge was an important factor for change [ 17 ].…”

Section: Discussionsupporting

confidence: 92%

Increased knowledge makes a difference! – general practitioners’ experiences of pictorial information about subclinical atherosclerosis for primary prevention: an interview study from the VIPVIZA trial

Bengtsson

Lindvall

Norberg

et al. 2021

Scandinavian Journal of Primary Health Care

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Objectives To explore how pictorial information on subclinical atherosclerosis affects GPs’ perception of patient cardiovascular disease (CVD) risk, their communication with patients, and GPs’ attitude to the treatment of CVD risk factors. Design, setting and subjects Fifteen individual interviews were conducted between March 2014 and December 2016, with GPs who had received pictorial information regarding their patients’ subclinical atherosclerosis. The pictorial information was also received by the patients together with written information regarding atherosclerosis and CVD risk prior to the appointment with their GP. The interviews were recorded, transcribed and analyzed using qualitative content analysis. Results Three categories were identified in the analysis. Increased knowledge makes a difference: When patients had more in-depth knowledge regarding atherosclerosis, the consultation became more patient-centered and moved towards shared decision making. This is real, not just a number: GPs described their risk assessment and the patient’s risk perception as more accurate with pictorial information about subclinical atherosclerosis. How to deal with the result – A passive to active approach: Some GPs acted promptly on the pictorial information while others took no action. Conclusion and implications Pictorial information regarding patients’ subclinical atherosclerosis affected GPs’ assessment of CVD risk. The communication shifted towards shared decision-making although the GPs’ attitude to the result and treatment of CVD risk factors varied. Informing patients about examination results, both in writing and pictures, prior to a consultation can facilitate shared decision making and enhance preventive measures. Trial registration https://clinicaltrials.gov/ct2/show/NCT01849575 . KEY POINTS Providing pictorial information about carotid ultrasound results and information regarding atherosclerosis to GPs and patients affects primary prevention: •Informing patients about examination results prior to a consultation can be useful in clinical practice to enhance preventive measures •GPs experienced that increased patient knowledge resulted in a more patient-centered consultation and improved shared decision-making •GPs described their risk assessment and patients’ risk perception as more accurate with pictorial information about subclinical atherosclerosis

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Section: Discussionsupporting

confidence: 92%

Increased knowledge makes a difference! – general practitioners’ experiences of pictorial information about subclinical atherosclerosis for primary prevention: an interview study from the VIPVIZA trial

Bengtsson

Lindvall

Norberg

et al. 2021

Scandinavian Journal of Primary Health Care

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“…Coronary artery disease (CAD) is one of the leading causes of mortality worldwide [15,16]. The early detection of CAD by non-invasive imaging is an important step to timely treat the disease and prevent cardiovascular events [17]. Non-invasive diagnosis of CAD can be done by functional imaging, detecting haemodynamic changes caused by CAD, or by anatomical imaging, where the coronary artery tree is evaluated.…”

Section: Diagnostic Classificationmentioning

confidence: 99%

Application of artificial intelligence in cardiac CT: From basics to clinical practice

Oever

Vonder

Assen

et al. 2020

European Journal of Radiology

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Research into the possibilities of AI in cardiac CT has been growing rapidly in the last decade. With the rise of publicly available databases and AI algorithms, many researchers and clinicians have started investigations into the use of AI in the clinical workflow. This review is a comprehensive overview on the types of tasks and applications in which AI can aid the clinician in cardiac CT, and can be used as a primer for medical researchers starting in the field of AI. The applications of AI algorithms are explained and recent examples in cardiac CT of these algorithms are further elaborated on. The critical factors for implementation in the future are discussed.

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“…Furthermore, a higher percentage of those who sought advice were commenced on risk factors controlling medications, antihypertensive and cholesterol lowering drugs, compared with controls. 13 The results of the study suggest that the optimum perception of cardiovascular risk that the individuals carry, particularly when clearly demonstrated to them using non-invasive tools of imaging subclinical atherosclerosis, plays an important role in encouraging adherence to medical treatment and lifestyle changes. The evidence is building up in supporting the invaluable role of sharing arterial imaging evidence of subclinical atherosclerosis with asymptomatic individuals carrying cardiovascular risks as an objective means for achieving better risk control and certainly satisfactory clinical outcome.…”

mentioning

confidence: 95%

“…12 In the current issue of the European Journal of Preventive Cardiology, there are interesting data supporting new approaches to improve subjects' education toward a healthy lifestyle in a sub-study from the Dutch Risk Or Benefit IN Screening for CArdiovascular disease (ROBINSCA) trial. 13 The ROBINSCA trial is a large population-based randomized controlled screening trial designed to investigate the difference between the traditional assessment of CVD risk, by means of the SCORE risk table, and an evaluation based on coronary artery calcification score performed by CT scanning. The study included a sub-analysis where both groups of participants received an online questionnaire to investigate prevention-seeking behaviour and compliance to preventive treatment.…”

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confidence: 99%

Imaging subclinical atherosclerosis promises better cardiovascular primary prevention

Faggiano

Dasseni

Henein

2019

Eur J Prev Cardiolog

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Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide with enormous social and economic cost implications. The ideal strategy for altering such a trend is optimum primary prevention. The European Society of Cardiology (ESC) guidelines 1 and recent American Heart Association/ American College of Cardiology (AHA/ACC) guidelines for CVD prevention 2 stress the central role of promoting a healthy lifestyle throughout life. The two guidelines recommend assessing conventional cardiovascular risk factors and calculate the 10-year risk of fatal CVD or 10-year probability of developing a first major cardiovascular event (myocardial infarction or stroke) by using the risk charts or scores. However, the benefit of using current CVD risk estimation models is limited. The use of the available tools, such as the SCORE of the ESC, may lead to serious underor over-estimation of cardiovascular risk, particularly in asymptomatic subjects considered at intermediate risk for events. Also, selected groups, such as young people and women, require special consideration for risk stratification. 3 Based on this, the ESC guidelines for CVD prevention proposed other factors that should be considered in order to better classify individuals into more appropriate risk categories. Among these factors is the search for objective evidence for subclinical atherosclerosis, such as coronary calcification and its score obtained by computed tomography (CT) or atherosclerotic plaque detection and measurements obtained from carotid artery ultrasound scans.Coronary artery scanning performed using cardiac CT and calculation of the Agatston calcium score is the most commonly used technique in clinical practice for detection of subclinical atherosclerosis, prognostic stratification of asymptomatic individuals and implementation of preventive strategies. Furthermore, like a coronary calcium score, a routine echocardiographic examination may offer an indirect evaluation of subclinical atherosclerosis disease by semi-quantitative assessment of cardiac calcifications at different sites, including the mitral apparatus (annulus, leaflets and papillary muscles), aortic valve and ascending aorta, that have been shown to predict future major coronary events, major cardiovascular events and mortality in asymptomatic subjects. 4,5 The Multi-Ethnic Study of Atherosclerosis, a population-based cohort with no known cardiovascular disease, reported the accuracy of coronary artery calcium score in predicting clinical events. A calcium score greater than 300 accurately identified subjects at high risk for future coronary heart disease events, with a hazard ratio of nearly 10. 6,7 Likewise, visualization of asymptomatic subclinical carotid atherosclerosis can improve an individual's risk classification and consequently guide towards a tailored optimum prevention strategy, one of the most important being lipid lowering therapy, and the eligibility for statin therapy. In 'The BioImage Study ', 8 Mortensen et al. proposed a personalized ap...

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Impact of a cardiovascular disease risk screening result on preventive behaviour in asymptomatic participants of the ROBINSCA trial

Cited by 27 publications

References 24 publications

Increased knowledge makes a difference! – general practitioners’ experiences of pictorial information about subclinical atherosclerosis for primary prevention: an interview study from the VIPVIZA trial

Increased knowledge makes a difference! – general practitioners’ experiences of pictorial information about subclinical atherosclerosis for primary prevention: an interview study from the VIPVIZA trial

Application of artificial intelligence in cardiac CT: From basics to clinical practice

Imaging subclinical atherosclerosis promises better cardiovascular primary prevention

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