Motivational effects of coronary artery calcium scores on statin adherence and weight loss

The Identification of Calcified Coronary Plaque Is Associated With Initiation and Continuation of Pharmacological and Lifestyle Preventive Therapies

“…Kalia et al (13) also found an increased OR of LLM continuation with increasing quartiles of CAC score after adjustment for age, sex, diabetes, hypertension, tobacco use, and family history of CAD (OR: 9.3; 95% CI: 4.1 to 20.8 comparing the fourth quartile of CAC score [CAC ≥526] vs. first quartile [CAC = 0 to 30]). Similarly, another study by Kalia et al (21) showed significantly higher rates of statin compliance in patients with hyperlipidemia with increasing CAC score categories compared with those with zero CAC after a mean follow-up of 4.1 years (statin use in group with CAC ≥400: 59% vs. CAC = 0: 28%). However, this study did not provide any data on baseline statin use and thus was not included in our meta-analysis.…”

“…Rozanski et al (8) reported a significant increase in the odds of exercising in the nonzero CAC group but reported no significant change in weight from baseline to follow-up at 4 years after CAC scan (change in weight: 1 lb [25th to 75th percentile: −5 to 8 lbs]; in CAC = 0 group, −3 lbs [25th to 75th percentile: −10 to 3 lbs] in CAC ≥400 group). A large study by Kalia et al (21) that investigated the motivational effects of CAC scores on weight loss with a follow-up period of 4.1 ± 3.2 years after an initial CAC scan reported a significant increase in the proportion of patients with measurable weight loss in groups with higher CAC scores compared with those with zero CAC. These findings suggest that knowledge of CAC scores could promote behavioral modifications that result in weight loss; however, more studies are needed to confirm this effect.…”

Detection and quantification of coronary calcium from dual energy chest x‐rays: Phantom feasibility study

“…Emerging studies of patient behaviors have demonstrated that showing patients images of proven disease improves adherence to both statins and weight loss. 1,23,24 Since there is 50% statin adherence at 1 year 25 and 25%-40% at 5 years, 26 any improvements would increase quality-adjusted-life years and reduce costs. [27][28][29] We have determined that one can visualize coronary artery calcium in 2-shot, nongated dual energy chest x-rays 30,31 and that specialized dual energy coronary calcification (DECC) processing, can greatly improve visualization.…”

Nuevas guías ACC/AHA sobre el manejo de dislipemias: tiempo de implementar el score de calcio como herramienta de prevención primaria

“…Además, en dicho estudio, el 50% de los pacientes sin FRC presentaron calcificaciones coronarias (de los cuales casi el 20% presentaron CAC >100); mientras que el 30% de los pacientes con más de 2 FRC no presentaron calcificaciones (CAC 0). Además de mejorar significativamente la predicción de eventos con respecto a los scores de riesgo tradicionales y de otras herramientas como el eco-Doppler de vasos de cuello, el índice tobillo-brazo y la proteína C reactiva, el CAC mejora la adherencia a estatinas y aspirina, promueve una reducción de peso asociada a mejoras en el estilo de vida, y reclasifica el riesgo en hasta un 66% de los pacientes de riesgo intermedio (26% a elevado y 40% a bajo riesgo) [17][18][19][20] . En efecto, el CAC presenta una gran utilidad para la decisión de iniciar aspirina y/o estatinas como prevención primaria, habiendo sido esto reportado en subestudios del MESA.…”