IMAJ | volume 26
Journal 10, November 2024
pages: 630-635
1 Department of Internal Medicine C, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
2 Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
Summary
Background:
The Agatston coronary artery calcium (CAC) score is a decision-guiding aid for risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease.
Objectives:
To explore the real-life clinical experience of CAC testing by characterizing its indications, significance of scores, and corresponding lipid-lowering treatments
.
Methods:
A retrospective descriptive study of patients treated at the lipids clinic at Rabin Medical Center (Beilinson Campus), who underwent CAC score evaluation between 2017 and 2022 was conducted
. The data collected from electronic medical files included demographics, co-morbidities, indications for the test, CAC score levels, and the recommended therapeutic regimen
.
Results:
The study cohort included 88 patients. The main indication was assessment of the existence of atherosclerosis in cases where there was no clear indication for lipid lowering treatment (65, 74%). In most patients, there was no evidence of atherosclerosis (CAC = 0 AU, n=30) or only mild disease (CAC=1–99 AU, n=35). As the CAC score increased, more patients were prescribed lipid lowering treatments, from very few prescriptions in those with a CAC score of 0 AU and almost 100% among those with score of ≥ 400 AU. The factors that predicted CAC > 0 AU were male sex and older age.
Conclusions
: CAC scores should be used more often to determine risk assessment. Further analysis of the implications of scores between 0–400 AU is needed.