Abstract 12077: Coronary and Carotid Artery Imaging Support the 2013 American College of Cardiology/American Heart Association Statin Guidelines
Background: In 2013, the ACC/AHA Task Force on Practice Guidelines developed a new algorithm to estimate the 10-year risk for developing a first ASCVD event. The guidelines have met with some controversy, as they indicate that a higher proportion of individuals should receive preventive treatment (statins) than previous U.S. or European guidelines would suggest.
Objective: We sought to determine the association between AHA/ACC 10-year risk levels (<5%, 5-7.5%, >7.5%) and known markers of cardiovascular disease, such as calcium score (CAC) and carotid IMT (CIMT).
Methods: From a previous study, we prospectively collected data on 150 subjects undergoing 64-slice CT angiography and carotid ultrasonography (US). Data collection included demographics, laboratory values, medications, and CT and US results. We calculated the ACC/AHA risk score for patients ages 40-74 years who were not on statins. Data were analyzed using chi-square for linear trend, ANOVA followed by multiple pairwise comparisons with the Bonferroni correction of the p-value, and the Kruskal Wallis test.
Results: Of the 150, 79 patients (mean age 56.7±7.9 years, 73% male, 99% White) met the inclusion criteria. Of these patients, 44.3% (35/79) scored <5% risk, 15.2% (12/79) scored 5-7.5% risk and 40.5% (32/79) scored >7.5%. The median max CIMT was 1.66 mm and the median of six segment mean IMTs was 0.75 mm; subjects were stratified as greater or less than the median for each measure. Differences in known cardiac markers by risk group are shown in the table.
Conclusion: Risk categories defined by the AHA/ACC guideline show a strong association with carotid and CT markers of atherosclerosis. These data suggest that statin use in patients with a risk score of 7.5% or greater is reasonable. Further study in a more diverse population is required.
Author Disclosures: S.M. Szpunar: None. J. Frank: None. R. Aboufakher: None. R. Bess: None. G. Cohen: None.
- © 2014 by American Heart Association, Inc.