Prevention & lipidsCohort study
Guideline-Directed Application of Coronary Artery Calcium Scores for Primary Prevention of Atherosclerotic Cardiovascular Disease
- Prospective population-based cohort study
Authors' conclusion
The ACC/AHA and ESC/EAS guidelines differ in the selection and application of the CAC score for primary prevention of ASCVD. Guideline-directed application of CAC score in a middle-aged apparently healthy population improved risk stratification at an acceptable NNT10y for both guidelines.
Study context
- Population
- Statin-naive adults 55 to 75 years, free of atherosclerotic cardiovascular disease (ASCVD) and DM, LDL-C <190 mg/dL, Rotterdam Study
- Participants
- 1,903 adults
- Exposure
- Coronary artery calcium (CAC) scan eligibility and risk reclassification by ACC/AHA (pooled cohort equations (PCE)), ACC/AHA (PREVENT) and ESC/EAS (SCORE2) guidelines
Main finding
As reported in the abstract
Eligible for CAC scan
Men
Women
Observational data: associations, not effects.
Further findings
Uprisked and derisked individuals
- Proportions of uprisked and derisked individuals varied per guideline
ASCVD incidence among CAC-eligible individuals (ACC/AHA and ESC/EAS)
- Incidence rates ranged from
- 9.3 to 23.8 per 1,000 person-years
Estimated NNT10y to prevent 1 ASCVD event (high-intensity statin) · 10 years
- NNT10y varied from
- 11 to 26
Original publication
Guideline-Directed Application of Coronary Artery Calcium Scores for Primary Prevention of Atherosclerotic Cardiovascular Disease. JACC Cardiovasc Imaging. Published 5 March 2025. doi:10.1016/j.jcmg.2024.12.008
Summarised from the published abstract; every number is checked against it