Abstract
Background
Coronary artery calcium (CAC) is a surrogate marker of atherosclerosis. This study sought to determine whether patient visualisation of CAC images is an effective tool to sustain longer-term cardiovascular (CV) risk factor control in primary prevention.
Methods
In this randomised trial over 3 years in asymptomatic, statin-naïve, community dwelling individuals aged 40–70 years, with a CAC score 1–400, all participants received a CV risk discussion to address modifiable risk factors. Intervention participants (n=220) visualised their CAC image and were initiated on statin therapy. Control participants (n=229) were blinded to the CAC image and not prescribed statin therapy. Multivariable regression analysis was performed to calculate between-group difference-in-differences (DID) for change in Framingham risk score (FRS), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP), adjusting for sex, age, income, and education level.
Results
A greater reduction in FRS (adjusted β –3.7%; 95% CI –4.7% to –2.6%; p<0.001) and LDL-C (adjusted β –1.2 mmol/L; 95% CI –1.4 to –1.1; p<0.001) was observed in the intervention group compared with the control group. The strongest model r2 was observed for LDL-C, and predictors of change in SBP and FRS were similar, but neither the treatment arm nor the other variables were predictive of change in SBP.
Conclusion
Patient visualisation of CAC imaging combined with statin therapy is beneficial for improving predicted CV risk. Future studies are needed to investigate whether image visualisation motivates asymptomatic individuals with coronary atherosclerosis to improve other modifiable CV risk factors.
Coronary artery calcium (CAC) is a surrogate marker of atherosclerosis. This study sought to determine whether patient visualisation of CAC images is an effective tool to sustain longer-term cardiovascular (CV) risk factor control in primary prevention.
Methods
In this randomised trial over 3 years in asymptomatic, statin-naïve, community dwelling individuals aged 40–70 years, with a CAC score 1–400, all participants received a CV risk discussion to address modifiable risk factors. Intervention participants (n=220) visualised their CAC image and were initiated on statin therapy. Control participants (n=229) were blinded to the CAC image and not prescribed statin therapy. Multivariable regression analysis was performed to calculate between-group difference-in-differences (DID) for change in Framingham risk score (FRS), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP), adjusting for sex, age, income, and education level.
Results
A greater reduction in FRS (adjusted β –3.7%; 95% CI –4.7% to –2.6%; p<0.001) and LDL-C (adjusted β –1.2 mmol/L; 95% CI –1.4 to –1.1; p<0.001) was observed in the intervention group compared with the control group. The strongest model r2 was observed for LDL-C, and predictors of change in SBP and FRS were similar, but neither the treatment arm nor the other variables were predictive of change in SBP.
Conclusion
Patient visualisation of CAC imaging combined with statin therapy is beneficial for improving predicted CV risk. Future studies are needed to investigate whether image visualisation motivates asymptomatic individuals with coronary atherosclerosis to improve other modifiable CV risk factors.
| Original language | English |
|---|---|
| Article number | 276 |
| Pages (from-to) | S236 |
| Number of pages | 1 |
| Journal | Heart Lung and Circulation |
| Volume | 32 |
| Issue number | Supplement 3 |
| DOIs | |
| Publication status | Published - Jul 2023 |
| Event | Cardiac Society of Australia and New Zealand Annual Scientific Meeting 2023 - Adelaide Convention Centre, Adelaide, Australia Duration: 3 Aug 2023 → 6 Aug 2023 Conference number: 71st https://www.heartlungcirc.org/issue/S1443-9506(23)X0011-0 (Published Abstracts) https://www.aphrs.org/meetings/other-meetings/426-csanz-2023-the-71st-annual-scientific-meeting-of-the-cardiac-society-of-australia-and-new-zealand |