Abstract
BackgroundThe purpose of this study was to describe and analyze the relationship between statin benefit groups based on statin-intensity class of drugs and coronary artery calcium score (CACS) using multidetector computed tomography (MDCT) in an asymptomatic Korean population.MethodsA total of 3914 asymptomatic individuals (mean age: 55 ± 10 years; male: female = 2649: 1265) who underwent MDCT for health examination between January 2009 and December 2012 were retrospectively enrolled. They were categorized into three groups based on statin-intensity class of drugs (high-intensity (n = 1284, 32.8%); moderate-intensity (n = 1602, 40.9%) and low-intensity (n = 931, 23.8%) statin therapy groups) according to the American College of Cardiology (ACC)/American heart Association (AHA) 2013 guideline and the relationship between CACS and statin benefit group was analyzed. The statin benefit group was defined as individuals who should be considered moderate- and high-intensity statin therapy.ResultsTen-year atherosclerotic cardiovascular disease (ASCVD; 12.6 ± 5.3% vs. 2.9 ± 1.9%, p < 0.001) and CACS (98 ± 270 vs. 3 ± 2, p < 0.001) were significantly higher in the high-intensity group compared to the moderate-intensity statin therapy group. In the high-intensity statin therapy group, age [odds ratio: 1.299 (1.137–1.483), p < 0.001], male gender [odds ratio: 44.252 (1.959–999.784), p = 0.001], and fasting blood glucose [odds ratio: 1.046 (1.007–1.087), p = 0.021] were independent risk factors associated with CACS ≥300 on multivariate logistic regression analysis.ConclusionsCACS on MDCT might be an important complementary tool for cardiovascular disease risk stratification. This study indicates that individualization of statin therapy as well as lifestyle modification will be useful in asymptomatic individuals, especially those in whom high-intensity statin therapy is required.
Highlights
The purpose of this study was to describe and analyze the relationship between statin benefit groups based on statin-intensity class of drugs and coronary artery calcium score (CACS) using multidetector computed tomography (MDCT) in an asymptomatic Korean population
While screening for coronary artery calcium score (CACS) using multidetector computed tomography (MDCT) is not currently recommended for asymptomatic patients who are low risk (0 to 1 risk factor or a 10year risk 20%) according to the Framingham criteria, it may be useful in patients with intermediate risk [6, 7]
The purpose of this study was to describe and analyze the relationship between statin benefit groups based on statin-intensity class of drugs and CACS using MDCT in an asymptomatic Korean population according to the American College of Cardiology (ACC)/American heart Association (AHA) 2013 guideline
Summary
The purpose of this study was to describe and analyze the relationship between statin benefit groups based on statin-intensity class of drugs and coronary artery calcium score (CACS) using multidetector computed tomography (MDCT) in an asymptomatic Korean population. The most recent guidelines were published in 2013 by the American College of Cardiology (ACC) and the American heart Association (AHA), and addressed the prevention of cardiovascular diseases (CVD) by better assessing cardiovascular risks and the treatment of blood cholesterol [4, 5]. CACS has an excellent negative predictive value for excluding the presence of significant coronary artery disease [8, 9] It provides more important prognostic information for cardiovascular risk stratification than biomarkers like C-reactive protein [10, 11]. CACS may play a role in patient management and the prediction of cardiovascular event incidence
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