De-risking primary prevention: role of imaging.
Level 5 - mechanism / opinion, no new human data
Narrative review of literature and guidelines with no systematic review or meta-analysis methods
PubMed 34821189 · doi:10.1177/17539447211051248
What was done
The authors conducted a review using PubMed, MEDLINE, Google Scholar, and the Cochrane library to evaluate the prognostic role of coronary artery calcium (CAC) scoring for cardiovascular disease events, alongside the 2018 ACC/AHA cholesterol guidelines.
What was found
A CAC score of zero is associated with low cardiovascular disease event rates (~1% per year). According to the 2018 ACC/AHA guidelines, a zero score can be used to withhold statin therapy for 5 to 10 years before reassessment.
Why it matters
It highlights how absence of coronary calcification can act as a negative risk marker to de-escalate unnecessary statin therapy in primary prevention.
Limits
This is a narrative review without systematic inclusion criteria, risk of bias evaluation, or pooled meta-analytic numbers. The abstract does not specify the number of included studies or participants.
Cited by
- supports Clinical guideline committees state that if a patient has a coronary artery calcium score of zero, they do not need a statin.