Visualization of Coronary Artery Calcification: Influence on Risk Modification

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BACKGROUND: Direct health provider to patient presentation of coronary computed tomography angiography (CTA) findings may increase adherence to preventive therapy and risk modification. The purpose of this study was to assess the influence of visualization of coronary artery calcification and lifestyle recommendations on cholesterol concentrations and other risk variables in symptomatic patients with non-obstructive coronary artery disease and hyperlipidemia.

METHODS: Prospective two-center randomized controlled trial. Patients were randomized 1:1 to intervention or standard follow-up in general practice. The primary end-point was change in plasma total-cholesterol concentration at 6-months follow-up.

RESULTS: We included 189 patients (mean [± SD] age 61 [12] years, 57% males). Median (range) Agatston score was 166 (70-2054). The reduction in plasma total-cholesterol concentrations tended to be higher in the intervention than in the control group, 51.04 mg/dL vs. 45.63 mg/dL (P = 0.181). In a subgroup including patients continuing statin therapy during follow-up (n = 147), the reduction in plasma total-cholesterol concentrations was more pronounced in the intervention than in the control group, 66.13 mg/dL vs. 55.68 mg/dL (P = 0.027). In the intervention group there was a higher degree of statin adherence and a higher proportion of patients who stopped smoking and commenced a healthier dietary behavior than in the control group.

CONCLUSION: Visualization of coronary artery calcification and brief recommendations about risk modification after coronary CTA in symptomatic patients with non-obstructive coronary artery disease and hyperlipidemia may have a favorable influence on plasma total-cholesterol concentration, adherence to statin therapy and risk behavior. Further investigations are needed.

OriginalsprogEngelsk
TidsskriftThe American Journal of Medicine
ISSN0002-9343
DOI
StatusUdgivet - 21 apr. 2015

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