10-Year CVD Risk Prediction & Calcium Buildup
New Study Reveals PREVENT Tool Combined with CAC Score Enhances Heart Attack Risk Prediction
New York, NY – A groundbreaking study published in the Journal of the American Heart association has demonstrated that combining the PREVENT risk assessment tool with Coronary Artery Calcium (CAC) scores significantly improves the accuracy of predicting future heart attacks, notably in individuals with subclinical cardiovascular disease. The research, conducted at NYU Langone Health, analyzed over 9 million electronic health records, offering valuable insights for refining cardiovascular risk stratification and guiding treatment decisions.
The PREVENT tool, developed by the American Heart Association, assesses the risk of total cardiovascular disease by incorporating factors related to cardiovascular health, kidney health, and metabolic health. While effective on its own, this new study highlights its enhanced predictive power when augmented by CAC scores, a measure of calcified plaque in the coronary arteries.Researchers found a strong correlation between PREVENT risk categories and CAC scores.Participants with a “low-to-mildly elevated” PREVENT risk, indicating a low likelihood of heart attack, typically had CAC scores of 1 or less. Conversely, those categorized as “moderate-to-high” risk by PREVENT often exhibited CAC scores exceeding 100, signifying a moderate-to-high risk of heart attack.”The findings illustrate that PREVENT is accurate in identifying people who may have subclinical risk for cardiovascular disease, meaning blocked arteries before symptoms develop,” saeid Dr.Lawrence Grams, the study’s lead author. “This study used a real-world set of patients, so our findings are important in shaping future guidelines on the use of the PREVENT calculator and coronary computed tomography angiography.”
The study involved 6,961 adults aged 30 to 79 with no prior history of heart disease. their average age was 57.5 years,with 53% being women and 77% identified as white. Over an average follow-up period of 1.2 years, 485 heart attacks occurred. The analysis compared the predictive accuracy of the PREVENT tool alone,CAC scores alone,and the combined PREVENT and CAC approach against actual heart attack occurrences. The combined method proved to be the most effective in identifying individuals at higher risk who later experienced a heart attack.
Dr.Sadiya Khan, a study co-author and American Heart Association volunteer expert, emphasized the utility of CAC scores in assessing risk. “CT scans to evaluate for coronary calcium and extent of coronary artery calcium buildup may be useful when patients are uncertain if they want to start lipid-lowering therapy or if lipid-lowering therapy should be intensified,” Dr.Khan stated. “We have so many tools in our armamentarium for reducing risk of heart attack, we want to be able to optimize treatments for patients, and especially those with higher risk.”
Despite the study’s significant findings,researchers acknowledged several limitations. The data was collected from a single institution, and the majority of participants were white, which may limit the generalizability of the results to broader populations. The analysis was also confined to individuals who had undergone coronary calcium screening, possibly overestimating the prevalence of coronary artery calcium in lower-risk individuals. Furthermore, the follow-up period was relatively short, and the presence of non-calcified plaque was not assessed.
Still, the study provides compelling evidence that integrating CAC scores with the PREVENT tool offers a more robust strategy for identifying individuals at elevated risk of heart attack, paving the way for more personalized and effective cardiovascular care.