Author + information
- Received July 20, 2007
- Revision received November 14, 2007
- Accepted November 19, 2007
- Published online April 8, 2008.
- Allen J. Taylor, MD⁎,†,⁎ (, )
- Jody Bindeman, BSN⁎,
- Irwin Feuerstein, MD⁎,†,
- Toan Le, ScD⁎,
- Kelly Bauer, BSN⁎,
- Carole Byrd, LVN⁎,
- Holly Wu, MD⁎ and
- Patrick G. O’Malley, MD, MPH⁎,†
- ↵⁎Reprint requests and correspondence:
Dr. Allen J. Taylor, Chief, Cardiology Service, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Building 2, Room 4A34, Washington, DC 20307-5001.
Objectives We examined the association of coronary artery calcium (CAC) detected on a screening exam with subsequent statin and aspirin usage in a healthy male screening cohort.
Background Whether the presence of CAC, an independent predictor of coronary heart disease outcomes, alters clinical management, such as the use of preventive medications, is unknown.
Methods Men (n = 1,640) ages 40 to 50 years (mean 42 years) were screened for coronary heart disease risk factors and CAC. The CAC scores and risk factors were reported to patients, and results were made available in the electronic medical record; however, medications were not prescribed or recommended by the study. During up to 6 years of subsequent annual structured telephone follow-up, we observed the community-based initiation and persistence of aspirin and statin therapy.
Results A progressive increase in the incidence of pharmacotherapy was noted over time such that those with CAC were 3 times more likely to receive a statin (48.5% vs. 15.5%, p < 0.001) and also significantly more likely to receive aspirin (53.0% vs. 32.3%; p < 0.001) than those without CAC. In multivariable models controlling for National Cholesterol Education Program risk variables and baseline medication use, CAC was strongly and independently associated with use of either statin (odds ratio [OR] 3.53; 95% confidence interval [CI] 2.66 to 4.69), aspirin (OR 3.05; 95% CI 2.30 to 4.05) or both (OR 6.97; 95% CI 4.81 to 10.10).
Conclusions In this prospective cohort, the presence of coronary calcification was associated with an independent 3-fold greater likelihood of statin and aspirin usage.
This work was fully supported by an independent, competitive grant award from the federally funded, congressionally directed, Peer Reviewed Medical Research Program, grant number ERMS 00239017-00216. Dr. Taylor has worked as a consultant for companies that market statin drugs (Merck and Pfizer). He receives grant support from Abbott Pharmaceuticals.
- Received July 20, 2007.
- Revision received November 14, 2007.
- Accepted November 19, 2007.
- American College of Cardiology Foundation