TOPLINE

A short self-report questionnaire was used to identify middle-aged adults for targeted CT imaging of coronary artery calcium (CAC). Predicted and actual prevalence of CAC score ≥100 matched closely, and many individuals with high CAC were not on lipid-lowering treatment.

METHODOLOGY

• In a prospective observational study, researchers assessed whether a self‑report questionnaire could identify individuals likely to have CAC who could then undergo targeted CT imaging.
• They randomly invited 8000 individuals aged 59-60 years in Sweden to complete a 14-item online questionnaire between September and November 2023.
• A predefined model estimated the probability of an individual having a CAC score ≥ 100. Individuals with a predicted probability of 15.3% or higher for CAC score ≥100 were classified as high risk and were offered clinical assessment and a noncontrast CT scan.
• The primary outcome was the correspondence between model-predicted probabilities and actual CT scan results for CAC ≥ 100. Researchers calculated the Brier score to evaluate prediction accuracy; lower scores indicate better accuracy.

TAKEAWAY

• A total of 2588 individuals completed the questionnaire (46.8% men); 814 were classified as having a high risk for CAC ≥100, and 563 completed coronary CT scans.
• The mean predicted probability for CAC ≥100 estimated by the model was 28.3%, which matched the observed prevalence of 28.4%; the ratio of expected to observed prevalence was 0.99, and the Brier score was 0.19.
• Among individuals with CAC ≥100, 64% were not taking any lipid-lowering therapy, and only 8% were receiving treatment and had low-density lipoprotein cholesterol at or below the target level of 1.8 mmol/L.
• Among individuals who completed CT scans, 12.6% had a CAC score ≥ 300.

IN PRACTICE

"[The] findings suggest that simple self-report data may support pragmatic preselection for CAC imaging and help identify opportunities for preventive treatment optimisation among individuals with elevated CAC," the researchers wrote.

SOURCE

The study was led by Eva Hagberg of University of Gothenburg, Gothenburg, Sweden. It was published online on September 21 in Heart.

LIMITATIONS

Only 32% of invited people responded. Some participants labeled high risk did not attend the clinic visits. CT imaging was limited to individuals at high risk, which limited the evaluation of the model in those at lower risk.

DISCLOSURES

The study received support from the Heart and Lung Foundation, the Swedish Research Council, and LUA/ALF (a Swedish research-funding agreement). The authors did not declare any competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.