TDNet Discover

Background. Cardiovascular disease continues to plague numerous lives in the United States, and early detection can be lifesaving. Traditional risk stratification methods have left what is believed to be the lowest risk population with chances of more drastic outcomes related to cardiovascular disease. Objective. To determine if using coronary artery calcium scoring better identifies individuals at risk for atherosclerosis when compared to traditional risk stratification tools. Methods. Beginning in December of 2019, the researchers began an evidence-based medicine systematic review of literature on three databases: Medline Complete, PubMed, and Google Scholar. Key search terms included “Coronary artery calcium AND low risk screening AND subclinical atherosclerosis,” “Coronary calcium score AND risk stratification,” and “Coronary artery calcium screening.” Search results were confined to the last ten years, in English text, and using human test subjects. Results were then narrowed using inclusion and exclusion criteria determined prior to the search. Each article was then independently reviewed and only included if two of three researchers agreed. A quality assessment was completed on each article. Results. Three articles were selected for final inclusion into the review, two being meta-analyses and one being a systematic review. Upon dual, independent review two articles were rated as “Fair” and one article was rated as “Good.” Across the three included articles, researchers found an increase in reclassification when using CAC scoring in addition to traditional risk stratification tools in intermediate-risk populations. This finding suggests that by adding a CAC score to the CAD screening process, patient risk was more accurately categorized. Conclusions. To date, little research has been conducted regarding CAC scoring in low risk populations. Future research should focus on more direct testing and evaluation of costs and benefits for low-risk populations