CHICAGO – Patients given a look at their coronary artery calcium CT scans are more likely to undertake cardiovascular risk reduction measures.
Further, the more abnormal the coronary artery calcium (CAC) score and its corresponding cardiac CT scan, the better the subsequent patient adherence with recommended risk reduction measures. So CAC scores are useful not only for risk stratification, but also for improving adherence to measures aimed at lowering risk, according to Dr. Nove Kalia of the University of Saskatchewan, Saskatoon.
Dr. Nove Kalia
He presented two related studies showing that patients who viewed their own CAC CT scan and had an elevated CAC score were more likely to lose weight and to adhere to prescribed statin therapy. He carried out both studies at Harbor-UCLA Medical Center in Torrance, Calif.
The weight loss study included 518 subjects followed for a mean of 3 years after their initial CAC CT scan. All participants were shown their scans and the significance of their CAC score was explained to them.
Any measurable weight loss at 3 years of follow up was present in 22% of subjects with a CAC score of 0, in 36% of those with a score of 1-99, in 32% of those with a score of 100-399, and in 38% of those with a score of 400 or above.
Compared to patients with a CAC score of 0, the likelihood of weight loss was 2.0-fold greater in patients with a CAC score of 1-99, 3.6-fold greater in those with a score of 100-399, and 3.3-fold greater in patients with a CAC score of 400 or above.
The higher the CAC score, the greater the average weight loss, ranging from 5 pounds in those with a score of 1-99 to 15 pounds with a score of 400 or greater.
"I think visualizing these coronary artery calcium images may be an important means of motivating patients even in an era of economic austerity," Dr. Kalia asserted. "The extra motivation you get from visualizing these images is helpful and probably translates into reduced long-term effects of coronary artery disease."
The statin adherence study involved 2,100 patients. At a mean follow up of 3 years, responses to a comprehensive patient questionnaire revealed that 36% of patients with a CAC score of 0 were compliant with their prescribed statin therapy, as compared to 52% of those with a CAC score of 1-99, 57% with a score of 100-399, and 59% with a CAC score of 400 or greater.
Compared to those with a CAC score of 0, adherence to statin therapy was 2.0-fold greater in patients with a score of 1-99, 2.4-fold greater with a score of 100-399, and 2.6-fold greater with a score of 400 or more.
Dr. Kalia reported having no financial conflicts.