Pre-screening to guide coronary artery calcium scoring for early identification of high-risk individuals in the general population

Journal Article · 18 July 2022 · European Heart Journal - Cardiovascular Imaging

DOI: https://doi.org/10.1093/ehjci/jeac137 · OSTI ID:1905643

Ties, Daan ; van der Ende, Yldau M. ; Pundziute, Gabija ; van der Schouw, Yvonne T. ; Bots, Michiel L. ; Xia, Congying ; van Ooijen, Peter M. A. ; Pelgrim, Gert Jan; Vliegenthart, Rozemarijn ; van der Harst, Pim

Abstract Aims To evaluate the ability of Systematic COronary Risk Estimation 2 (SCORE2) and other pre-screening methods to identify individuals with high coronary artery calcium score (CACS) in the general population. Methods and results Computed tomography-based CACS quantification was performed in 6530 individuals aged 45 years or older from the general population. Various pre-screening methods to guide referral for CACS were evaluated. Miss rates for high CACS (CACS ≥300 and ≥100) were evaluated for various pre-screening methods: moderate (≥5%) and high (≥10%) SCORE2 risk, any traditional coronary artery disease (CAD) risk factor, any Risk Or Benefit IN Screening for CArdiovascular Disease (ROBINSCA) risk factor, and moderately (>3 mg/24 h) increased urine albumin excretion (UAE). Out of 6530 participants, 643 (9.8%) had CACS ≥300 and 1236 (18.9%) had CACS ≥100. For CACS ≥300 and CACS ≥100, miss rate was 32 and 41% for pre-screening by moderate (≥5%) SCORE2 risk and 81 and 87% for high (≥10%) SCORE2 risk, respectively. For CACS ≥300 and CACS ≥100, miss rate was 8 and 11% for pre-screening by at least one CAD risk factor, 24 and 25% for at least one ROBINSCA risk factor, and 67 and 67% for moderately increased UAE, respectively. Conclusion Many individuals with high CACS in the general population are left unidentified when only performing CACS in case of at least moderate (≥5%) SCORE2, which closely resembles current clinical practice. Less stringent pre-screening by presence of at least one CAD risk factor to guide CACS identifies more individuals with high CACS and could improve CAD prevention.

• Sponsoring Organization: USDOE Office of Science (SC), Fusion Energy Sciences (FES)
• OSTI ID: 1905643
• Journal Information: European Heart Journal - Cardiovascular Imaging, Journal Name: European Heart Journal - Cardiovascular Imaging Journal Issue: 1 Vol. 24; ISSN 2047-2404
• Publisher: Oxford University PressCopyright Statement
• Country of Publication: Country unknown/Code not available
• Language: English