Abstract P532: Risk Factor Differences for Coronary Artery Calcium in Self versus Provider-Referred Groups

Abstract

Introduction: To detect coronary artery disease (CAD) in asymptomatic patients, noninvasive coronary artery calcium (CAC) computed tomography (CT) can be used in the decision to start statin or further lipid lowering management. The test is appropriate for adult patients 40-75 years old at 10-year atherosclerotic cardiovascular disease intermediate risk (7.5-20%) without diabetes mellitus and with low-density lipoprotein cholesterol 70-189 mg/dL. The study was to identify risk factor differences between self and provider-referred groups. We hypothesized that the provider-referred group would have greater risk factors. Methods: Patients who received CAC CT at seven southwest Ohio hospitals for the first 6 months of 2019 were self or provider-referred for CAC CT during a community campaign for persons who identified as having cardiovascular risk factors. Their background information and labs were obtained and compared to ascertain differences. Results: The analyses involved 2124 patients who received CAC CT. 163 were self and 1961 were provider-referred. With 30 demographic and clinical risk factors compared, peripheral vascular disease, higher triglyceride levels, higher LDL and beta blocker prescription were associated with higher odds for elevated CAC score in the self-referred group. There was no difference between white or black races. Conclusion: CAC CT testing can be used to clarify cardiovascular risk and to optimize medical therapy for both self and provider-referred groups. Self-referred patients seem to identify with similar or advanced awareness of risk factors for primary prevention concerns when a community initiative was issued. Therefore, community initiatives may have a public health benefit for primary prevention and early detection of cardiac risk. This is a study that may be repeated in other communities.