CAC score-informed preventive care slows down the plaque progress in the family CAD

Photo credit: iStock.com/pepe Gallardo

The researchers found that the CAC score-depicted preventive strategies were bound to fewer plaque progress in patients with medium risk with family premature CAD.

In a study of patients with a medium risk with a family history before the early coronary artery disease (CAD), the Coronarartery Calcium (CAC) Schustüroberkscapen strategies over a period of 3 years were associated with a significantly less plaque progression, according to the online results in Jama.

“Cacium (CAC) coronary arteries (CAC) provides prognostic information, especially in patients with medium risk for an illness of coronary arteries (CAD).” First author Nitesh Nerlekar, MBBS, MPH, PhD, from the Baker Heart and Diabetes Research Institute, and colleague wrote and found that the advantage of the combination of CAC score with a primary prevention strategy did not have to be tested in a randomized study.

Study design and participants

The prospective, randomized study by the team comprised 365 asymptomatic, statin-naive adults aged 40 to 70 years from seven Australian hospitals. The authorization required a first degree relative to the beginning of CAD 60 years ago or a related second degree with a CAD start before the age of 50 and a basic CAC score between 1 and 399.

The participants were randomized to both:

• Usual care: Standard CAD prevention education and annual re -evaluation over 3 years of lipid profiles and risk factors, whereby statins were prescribed at the discretion of the doctor. Blind for CAC score.
• CAC-score-in-formed preventive care: a structured intervention guided by the nurse using the CTA images of the participants to communicate a personalized risk, combined with self-management training, lifestyle advice and lipidless therapy ((40 mg daily atorvastatin). The follow-up took place in intervals of 6 months over 3 years.

“The intervention was based on a standardized, nursing-based intervention in which the CT images of the participants were used to communicate through illnesses,” said the researchers. “Intervention included education about the self -management of risks and lifestyle, care coordination and risk change.”

Lipid and Plaque results

After 3 years, the CAC score-depicted cohort showed a larger persistent lipid improvement: the mean total cholesterol was removed by 56 mg/dl compared to 3 mg/dl in the usual care car locations, and the Lipoproprie-cholesterol infinery with a low density decreased by 51 mg/dl (both (both (both (both P<0.001), according to findings.

Both cohorts showed a progressive accumulation of Plaque; In the CAC score, however, a less progression was in:

• Total plaques volume
• Non -calcified plaque volume
• Fibrofatty and necrotic core volumes

These reductions were independent of the basic plaque load and traditional risk factors, as the authors stated.

Clinical implications

“The combination of the CAC scores with a primary prevention strategy in patients with medium risk with a family history from CAD was associated with the reduction in atherogenic lipid and slower plaque progression compared to the usual care,” concluded the researchers. “This data supports the use of CAC score to support intensive prevention strategies in patients with medium risk.”