Effectiveness of CT Cardiac Score (CACS) as Risk Stratification Tool in Primary Care
A study conducted in a primary care practice evaluated the use of CT Cardiac Score (CACS) for risk assessment in patients without classic heart disease symptoms. Patients with CACS over 1,000 were not considered high risk by traditional assessments. Integrating CACS testing in routine evaluations could offer a cost-effective way to categorize patients into low, medium, and high-risk groups for heart attacks, potentially leading to life-saving interventions.
- CT Cardiac Score
- Risk Stratification
- Primary Care Practice
- Coronary Artery Disease
- Cardiac Risk Assessments
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Presentation Transcript
The Research Question Is CT Cardiac Score (CACS) as an Affordable Risk Stratification Strategy in a Primary Care Practice? One in every four deaths in the US is caused by coronary artery disease 630,000 deaths per year One third of patients present as their first symptom of heart disease with a myocardial infarction One third of those patients die at the time of their first symptom
Research Design and Method Study was conducted in a solo family practice in Granite Falls, NC from January 2014-December 2017 with 76 patients Clinical decisions for ordering CACS were based on CV Framingham risk profile, symptom history and family history CT cardiac score > 1,000, referral was made to a cardiologist CT cardiac score < 1,000, the patient remained under the care of the physician and treated aggressively with risk modification
What the Research Found 9 patients with Coronary Artery Calcium Score (CACS) > 1,000 were not considered high risk according to FRS They did not indicate any classic symptoms of heart disease (many had anginal equivalent symptoms-extreme fatigue, exertional dyspnea, unexplained diaphoresis, atypical chest pain) Much like screening for prostate cancer, there continues to be doubt surrounding how to proceed once an elevated CACS exists Test inclusion in typical risk assessments could be a valuable and cost-effective way to stratify risk into low, medium and high risk for myocardial infarction
What this means for Clinical Practice CACS is another tool to add to our list of coronary artery disease risk factor screening tests CACS has the potential to stimulate patients to mitigate their overall risk and, in some cases, lead to life saving interventions After cardiac intervention, patients anginal equivalent symptoms had resolved completely
