Miles Brittany, Theng Bunnarin, Etumuse Bright O, Zeinoddini Atefeh, Saleem Arsalan
John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
Department of Radiology, Baylor University Medical Center, Dallas, Texas, USA.
Proc (Bayl Univ Med Cent). 2023 Jul 31;36(5):586-589. doi: 10.1080/08998280.2023.2239083. eCollection 2023.
Coronary artery calcium (CAC) scoring helps determine whether patients with known coronary artery disease (CAD) should initiate medical management by predicting future cardiac event risk. CAC scoring is underutilized because many insurance companies consider it experimental. This study aimed to determine whether CAC screening of patients at risk for CAD is associated with decreased risk of myocardial infarction and improved survival.
The TriNetX research network was used for this study. Two cohorts of 86,574 patients aged 40 to 70 years were created. All patients were diagnosed with dyslipidemia and without CAD, and the cohorts were matched for demographics, comorbidities, and statin use. One cohort had been screened with CAC scoring while the other had not. The primary outcomes of this study were myocardial infarction and overall survival at 5 years.
Screened patients had 44% fewer myocardial infarction events at 5 years with a 76% lower risk of death.
CAC scoring is associated with reduced risk of myocardial infarction and death in asymptomatic dyslipidemia patients and should be considered as a screening tool in these patients. The presumed mechanism for improved outcomes is that early identification of CAD results in earlier or more intensive treatment, reducing future cardiac event risk.
冠状动脉钙化（CAC）评分有助于通过预测未来心脏事件风险来确定已知冠状动脉疾病（CAD）患者是否应开始药物治疗。由于许多保险公司认为CAC评分是试验性的，因此该评分未得到充分利用。本研究旨在确定对CAD风险患者进行CAC筛查是否与降低心肌梗死风险和提高生存率相关。
本研究使用了TriNetX研究网络。创建了两组各86574名年龄在40至70岁之间的患者。所有患者均被诊断为血脂异常且无CAD，两组在人口统计学、合并症和他汀类药物使用方面进行了匹配。一组接受了CAC评分筛查，而另一组未接受。本研究的主要结局是5年时的心肌梗死和总体生存率。
接受筛查的患者在5年时心肌梗死事件减少44%，死亡风险降低76%。
CAC评分与无症状血脂异常患者心肌梗死和死亡风险降低相关，应被视为这些患者的筛查工具。改善结局的推测机制是早期识别CAD可导致更早或更强化的治疗，降低未来心脏事件风险。
