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Effect of Patient Visualization of Coronary Calcium by Electron Beam Computed Tomography on Changes in Beneficial Lifestyle Behaviors

2008; Elsevier BV; Volume: 101; Issue: 7 Linguagem: Inglês

10.1016/j.amjcard.2007.11.059

1879-1913

Raza H. Orakzai, Khurram Nasir, Sarwar H. Orakzai, Nove Kalia, Ajay K. Gopal, Yan V. Sun, Roger S. Blumenthal, Matthew J. Budoff,

Cerebrovascular and Carotid Artery Diseases

Despite convincing data demonstrating the benefits of aspirin (ASA), exercise, and dietary changes for both primary and secondary prevention of coronary heart disease, they remain underused. In this study, we assess whether higher coronary artery calcium (CAC) scores determined by electron beam computed tomography (EBCT) are associated with beneficial lifestyle behaviors in asymptomatic individuals. A total of 980 asymptomatic patients referred for EBCT risk assessment by their primary physician were sent a survey questioning them about health behaviors. We evaluated long-term ASA utilization, exercise, and dietary changes based on CAC using multivariable analysis. The study population consisted of 980 individuals (78% men, mean age 60 +/- 8 years) who were followed for a mean of 3 +/- 2 years after an initial EBCT scan. Overall, ASA initiation was lowest (29%) among those with CAC = 0, and gradually increased with higher CAC scores (1 to 99, 55%; 100 to 399, 61%; > or =400, 63%; p or =400, 56%; p or =400, 67%; p <0.001 for trend for exercise). In multivariable analysis, greater baseline CAC was strongly associated with initiation of ASA therapy, dietary changes, and increased exercise. In conclusion, in addition to risk stratification of asymptomatic individuals, determination of CAC may also improve utilization of ASA therapy and behavioral modification.