Kalia Nove K, Cespedes Lucas, Youssef George, Li Dong, Budoff Matthew J
Department of Internal Medicine, LA Biomedical Research Institute at Harbor-UCLA, Torrance, California, USA.
Coron Artery Dis. 2015 May;26(3):225-30. doi: 10.1097/MCA.0000000000000207.
The aim of this study was to assess the effect on adherence to statin therapy and assess the effect of beneficial changes in behavior that resulted in weight loss in patients who underwent coronary artery calcium (CAC) scoring with cardiac computed tomography.
Despite convincing data demonstrating the benefits of HmGCoA inhibitors for both primary and secondary prevention of coronary heart disease, they remain underused. Also, despite convincing data demonstrating the benefits of weight loss for both primary and secondary prevention of coronary heart disease, it remains difficult to motivate behavioral changes resulting in weight loss. In this study, we assess whether higher CAC scores are associated with increased compliance with statin medication and whether higher CAC scores are associated with beneficial lifestyle behaviors resulting in weight loss.
We retrospectively analyzed patients that had undergone baseline CAC testing and returned for a follow-up scan. All patients had weight documented and were administered a questionnaire regarding compliance to medications. The primary endpoint was measurable weight loss between visit one and visit two and the self-reported compliance to statin use.
The study population with data regarding statin compliance consisted of 2608 individuals (72% men, mean age 58±8 years) who were followed for a mean of 4.1±3.2 years after an initial CAC scan. Overall, statin compliance was lowest (27.4%) among those with CAC=0, and gradually increased with higher CAC scores (1-99, 39.2%; 100-399, 53.6%; ≥400, 58.8%; P<0.001 for trend). In the group analyzed for weight loss the study population consisted of 1078 individuals (68% men, mean age 60±8 years) who were followed for a mean of 4.1±3.2 years after an initial CAC scan.
Overall, behavioral modification resulting in weight loss was lowest (19.8%) among those with CAC=0, and gradually increased with higher CAC scores (1-99, 23.4%; 100-399, 30.8%; ≥400, 33.6%; P<0.001 for trend). In addition to being a robust risk stratification tool, a higher rate of adherences with statin therapy was observed in patients with higher CAC scores.
本研究旨在评估冠状动脉钙化（CAC）心脏计算机断层扫描患者中，体重减轻导致的行为有益变化对他汀类药物治疗依从性的影响。
尽管有确凿数据表明HmGCoA抑制剂对冠心病的一级和二级预防有益，但它们的使用仍然不足。此外，尽管有确凿数据表明体重减轻对冠心病的一级和二级预防有益，但促使导致体重减轻的行为改变仍然很困难。在本研究中，我们评估较高的CAC评分是否与他汀类药物治疗依从性增加相关，以及较高的CAC评分是否与导致体重减轻的有益生活方式行为相关。
我们回顾性分析了接受基线CAC检测并返回进行随访扫描的患者。记录所有患者的体重，并发放一份关于药物依从性的问卷。主要终点是第一次就诊和第二次就诊之间可测量的体重减轻以及自我报告的他汀类药物使用依从性。
有他汀类药物依从性数据的研究人群包括2608名个体（72%为男性，平均年龄58±8岁），在首次CAC扫描后平均随访4.1±3.2年。总体而言，CAC=0的患者中他汀类药物依从性最低（27.4%），并随着CAC评分升高而逐渐增加（1-99，39.2%；100-399，53.6%；≥400，58.8%；趋势P<0.001）。在分析体重减轻的组中，研究人群包括1078名个体（68%为男性，平均年龄60±8岁），在首次CAC扫描后平均随访4.1±3.2年。
总体而言，CAC=0的患者中导致体重减轻的行为改变最低（19.8%），并随着CAC评分升高而逐渐增加（1-99，23.4%；100-399，30.8%；≥400，33.6%；趋势P<0.001）。除了是一种强大的风险分层工具外，在CAC评分较高的患者中观察到他汀类药物治疗的依从率更高。
