Comparison of coronary calcium screening versus broad statin therapy for patients at intermediate cardiovascular risk

The American Journal of Cardiology
Allan D SnidermanCurt D Furberg

Abstract

Net reclassification has become widely accepted as a method to demonstrate whether new diagnostic technologies add significantly to the discrimination of risk. However, more accurate categorization of risk does not necessarily result in a better clinical outcome. This study examined whether coronary artery calcium, a technology that improves net reclassification in patients at intermediate risk for cardiovascular events, is superior to a strategy that calls for broader intervention with statin therapy in these patients. To do so, the clinical impact and costs of 2 intervention regimens on outcome in the Multi-Ethnic Study of Atherosclerosis (MESA) were calculated based on the known efficacy of statins. Intervention 1 involved treatment of all subjects at conventional intermediate risk with moderate-dose stain, whereas intervention 2 involved moderate- and high-dose statin therapy, respectively, of those remaining at intermediate risk and those reassigned to high risk after reclassification by coronary artery calcium. The 2 strategies would decrease clinical events by 23% and would produce net savings. However, these would be greater with the broad statin prevention strategy than with the coronary calcium reclassification strate...Continue Reading

References

Jun 29, 2004·The American Journal of Cardiology·Donald M Lloyd-JonesDaniel Levy
Apr 29, 2010·JAMA : the Journal of the American Medical Association·Tamar S PolonskyPhilip Greenland
May 12, 2010·Journal of Clinical Pharmacy and Therapeutics·T-C WengS-H Tai
Nov 26, 2010·Circulation·Philip GreenlandUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
May 19, 2011·PharmacoEconomics·Amy K O'SullivanDavid Thompson
Oct 4, 2011·The American Journal of Cardiology·Patrick R LawlerLouise Pilote
Dec 23, 2011·Clinical Science·Allan D SnidermanCurt D Furberg

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Citations

Dec 17, 2014·Journal of Clinical Lipidology·Peter P TothAllan Sniderman
May 11, 2015·Progress in Cardiovascular Diseases·Allan SnidermanGeorge Thanassoulis
Mar 13, 2014·Circulation. Cardiovascular Quality and Outcomes·Mark J PletcherPhilip Greenland

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