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Abstract:

Background: Application of coronary artery calcium (CAC) for stratifying coronary heart disease (CHD) risk may change the proportion of subjects eligible for risk reduction treatment and decrease cost-effectiveness of primary prevention. We therefore aimed to analyze the impact of CAC on CHD risk categorization. Methods: We measured CAC with electron beam computed tomography in 500 asymptomatic untreated hypercholesterolemic men and re-calibrated 10-year Framingham CHD risk by adding CAC score information (post CAC test risk) via an algorithm integrating relative risk and expected distribution of CAC in the population tested. Proportions of low (< 10%), intermediate (10-20%) and high (> 20%) risk categories, and of eligibility for lipid-lowering treatment, were compared between Framingham risk and post CAC test risk. Results: In the overall population, post CAC test risk calculation changed risk categorization defined by Framingham assessment alone, with 10% more low risk and 10% less intermediate risk (p < 0.01). Risk reclassifications were bidirectional since 30% of high and 30% of intermediate Framingham risk were downgraded to intermediate and low risk categories respectively, while 11% of low and 14% of intermediate Framingham risk were upgraded to intermediate and high-risk categories respectively. Post CAC test risk did not change the proportion of Framingham-based lipid-lowering treatment eligibility in the overall population but decreased it by 8% in intermediate Framingham risk subgroup (p < 0.05). Conclusions: Addition of CAC to risk prediction resulted rather in downgrading than in upgrading risk and did not change treatment eligibility, except in intermediate risk subjects, less frequently eligible for treatment. © 2010 Elsevier Ireland Ltd.

Registro:

Documento: Artículo
Título:Impact of coronary artery calcium on cardiovascular risk categorization and lipid-lowering drug eligibility in asymptomatic hypercholesterolemic men
Autor:Chironi, G.; Simon, A.; Megnien, J.-L.; Sirieix, M.-E.; Mousseaux, E.; Pessana, F.; Armentano, R.
Filiación:Hôpital Européen Georges Pompidou, Centre de Médecine Préventive Cardiovasculaire, Centre de Recherche Cardiovasculaire de l'Hegp (INSERM U970), 20 rue Leblanc, 75908 Paris Cedex 15, France
Département de Radiologie Cardiovasculaire, Hôpital Européen Georges Pompidou, INSERM U678, Paris, France
Université Paris Descartes, Faculté de Médecine, Paris, France
Facultad de Ingeniería y Ciencias Exactas y Naturales, Universidad Favaloro, Buenos Aires, Argentina
Idioma: Inglés
Palabras clave:Calcium; Cholesterol; Computed tomography; Coronary disease; Prediction; antilipemic agent; calcium; adult; aged; article; cardiovascular risk; controlled study; coronary artery calcium test risk; disease association; electron beam tomography; Framingham risk score; human; hypercholesterolemia; hypertension; major clinical study; male; prediction; priority journal; risk assessment; smoking habit; Adult; Aged; Cardiovascular Diseases; Cholesterol; Coronary Vessels; Follow-Up Studies; France; Humans; Hypercholesterolemia; Hypolipidemic Agents; Incidence; Male; Middle Aged; Retrospective Studies; Risk Assessment; Risk Factors; Tomography, X-Ray Computed; Vascular Calcification
Año:2011
Volumen:151
Número:2
Página de inicio:200
Página de fin:204
DOI: http://dx.doi.org/10.1016/j.ijcard.2010.05.024
Título revista:International Journal of Cardiology
Título revista abreviado:Int. J. Cardiol.
ISSN:01675273
CODEN:IJCDD
CAS:calcium, 14092-94-5, 7440-70-2; Cholesterol, 57-88-5; Hypolipidemic Agents
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_01675273_v151_n2_p200_Chironi

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Citas:

---------- APA ----------
Chironi, G., Simon, A., Megnien, J.-L., Sirieix, M.-E., Mousseaux, E., Pessana, F. & Armentano, R. (2011) . Impact of coronary artery calcium on cardiovascular risk categorization and lipid-lowering drug eligibility in asymptomatic hypercholesterolemic men. International Journal of Cardiology, 151(2), 200-204.
http://dx.doi.org/10.1016/j.ijcard.2010.05.024
---------- CHICAGO ----------
Chironi, G., Simon, A., Megnien, J.-L., Sirieix, M.-E., Mousseaux, E., Pessana, F., et al. "Impact of coronary artery calcium on cardiovascular risk categorization and lipid-lowering drug eligibility in asymptomatic hypercholesterolemic men" . International Journal of Cardiology 151, no. 2 (2011) : 200-204.
http://dx.doi.org/10.1016/j.ijcard.2010.05.024
---------- MLA ----------
Chironi, G., Simon, A., Megnien, J.-L., Sirieix, M.-E., Mousseaux, E., Pessana, F., et al. "Impact of coronary artery calcium on cardiovascular risk categorization and lipid-lowering drug eligibility in asymptomatic hypercholesterolemic men" . International Journal of Cardiology, vol. 151, no. 2, 2011, pp. 200-204.
http://dx.doi.org/10.1016/j.ijcard.2010.05.024
---------- VANCOUVER ----------
Chironi, G., Simon, A., Megnien, J.-L., Sirieix, M.-E., Mousseaux, E., Pessana, F., et al. Impact of coronary artery calcium on cardiovascular risk categorization and lipid-lowering drug eligibility in asymptomatic hypercholesterolemic men. Int. J. Cardiol. 2011;151(2):200-204.
http://dx.doi.org/10.1016/j.ijcard.2010.05.024