Abstract 20067: Impact of Statins on Long-Term Cardiovascular Outcomes in Patients Undergoing Coronary Artery Calcium Scoring: Results From the Walter Reed Registry
Introduction: Coronary artery calcium (CAC) scoring significantly improves cardiovascular risk prediction as compared to standard cardiovascular risk factors. However, the impact of statins on atherosclerotic cardiovascular disease (ASCVD) events among subjects undergoing coronary calcium scoring is not known.
Methods: We identified consecutive subjects without pre-existing ASCVD or malignancy who underwent CAC scoring (Agatston) at Walter Reed Medical Center from 2001-2009. Outcomes, baseline risk factors, and individual prescription data were extracted from the military data repository, a comprehensive healthcare database that captures care provided within and outside of the military healthcare system. Patient-level death data were acquired from the National Death Index. Subjects were assessed for the primary outcome of first major adverse cardiac event (MACE), a composite of myocardial infarction, stroke and cardiovascular death. Outcomes were analyzed using Cox proportional hazard multivariate regression controlling for baseline ASCVD risk factors and using a time dependent variable to account for statin exposure.
Results: 14,956 patients (mean age 50 years; 71 % men) were followed for a mean of 9.3 ± 2.8 years. Among all patients, statin therapy was an independent predictor for reduced MACE (adjusted hazard ratio 0.79, 95% CI 0.66-0.94). Comparing statin treated patients to those not treated with statins, the number needed to treat (NNT) for 1 year to prevent one incident MACE outcome ranged from 3950.9 patients (CAC=0) to 45.3 patients (CAC >400) (Table 1).
Conclusion: In a large-scale cohort without baseline ASCVD, CAC presence and severity significantly risk stratified patients who are most and least likely to benefit from statin therapy during long-term follow-up.
Author Disclosures: J.D. Mitchell: None. N. Fergestrom: None. P. Moon: None. R. Paisley: None. T.C. Villines: None.
- © 2016 by American Heart Association, Inc.