Author + information
- Marcio Sommer Bittencourt,
- Michael Blaha,
- Ron Blankstein,
- Jose Vargas,
- Matthew Budoff,
- Arthur Agatston,
- Roger Blumenthal and
- Khurram Nasir
There is an increasing interest in single pills with a combination of low dose statin, blood pressure medications, and aspirin (polypills) as a population approach to reduce cardiovascular disease (CVD). We examined the value of coronary artery calcium (CAC) in the risk stratification of candidates meeting eligibility criteria for polypill administration.
6416 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) were included. Participants were stratified using the entry criteria of the proposed polypill studies (Wald criteria, TIPS, and HOPE-3). We compared coronary heart disease (CHD) and CVD event rates and calculated 5-year number needed to treat (NNT) based on the presence/absence of CAC.
In a median follow-up was 7.6 years, 200 (3.1%) CHD and 308 (4.8%) CVD events were noted. The results for the event rates, adjusted hazard ratios and the predicted 5-year NNT for CHD and CVD according to CAC for each of the polypill study criteria is presented in the table.
CAC seems to further stratify risk in patients eligible for polypill and a lower NNT to reduce future cardiac events. Focusing of treatment on the subset of individuals with measurable atherosclerosis could allow for more appropriate allocation of resources and reduced use of polypills in people more likely to be harmed by this combined approach.
Oral Contributions West, Room 3010
Saturday, March 09, 2013, 8:45 a.m.-9:00 a.m.
Session Title: Coronary Calcium and Cardiac CTA: Diagnosis Prognosis, New Insights
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 908-6
- 2013 American College of Cardiology Foundation