BACKGROUND: Many patients lack motivation to control cardiovascular risk factors and clinicians have long sought ways to activate apathetic patients. Despite significant and consistent data on the benefits of lipid-lowering agents to reduce cardiovascular events, adherence and utilization of these agents remains low. We evaluated whether visualization of coronary calcium would positively affect patients' adherence rates. METHODS: We evaluated patients who underwent electron beam tomography (EBT) coronary calcium evaluation at least 1 year prior with a survey questioning them about health behaviors. Patients filled out baseline and follow-up questionnaires relating to lifestyle modifications, including statin utilization, diet, exercise, tobacco cessation and vitamin/antioxidant utilization. RESULTS: The study population consisted of 505 individuals on statin therapy on baseline who were followed for a mean of 3 +/- 2 years. Overall the statin compliance was lowest (44%) among those with CAC score in the first quartile (0-30), whereas 91% of individuals with baseline CAC score in the fourth quartile (>or= 526) adhered to statin therapy. In multivariable analysis, after adjusting for cardiovascular risk factors, age, and gender, higher baseline CAC scores were strongly associated with adherence to statin therapy. CONCLUSIONS: In addition to risk stratification for the asymptomatic person, patients visualizing coronary artery calcium may improve utilization and adherence to lipid-lowering therapy. Outcome studies and randomized trials need to be done to quantify the true value and cost-effectiveness of this approach.
BACKGROUND: Many patients lack motivation to control cardiovascular risk factors and clinicians have long sought ways to activate apathetic patients. Despite significant and consistent data on the benefits of lipid-lowering agents to reduce cardiovascular events, adherence and utilization of these agents remains low. We evaluated whether visualization of coronary calcium would positively affect patients' adherence rates. METHODS: We evaluated patients who underwent electron beam tomography (EBT) coronary calcium evaluation at least 1 year prior with a survey questioning them about health behaviors. Patients filled out baseline and follow-up questionnaires relating to lifestyle modifications, including statin utilization, diet, exercise, tobacco cessation and vitamin/antioxidant utilization. RESULTS: The study population consisted of 505 individuals on statin therapy on baseline who were followed for a mean of 3 +/- 2 years. Overall the statin compliance was lowest (44%) among those with CAC score in the first quartile (0-30), whereas 91% of individuals with baseline CAC score in the fourth quartile (>or= 526) adhered to statin therapy. In multivariable analysis, after adjusting for cardiovascular risk factors, age, and gender, higher baseline CAC scores were strongly associated with adherence to statin therapy. CONCLUSIONS: In addition to risk stratification for the asymptomatic person, patients visualizing coronary artery calcium may improve utilization and adherence to lipid-lowering therapy. Outcome studies and randomized trials need to be done to quantify the true value and cost-effectiveness of this approach.
Authors: Benjamin Z Galper; Andrew Moran; Pamela G Coxson; Mark J Pletcher; Paul Heidenreich; Lawrence D Lazar; Nicolas Rodondi; Y Claire Wang; Lee Goldman Journal: Circulation Date: 2011-12-05 Impact factor: 29.690
Authors: Matthijs Oudkerk; Arthur E Stillman; Sandra S Halliburton; Willi A Kalender; Stefan Möhlenkamp; Cynthia H McCollough; Rozemarijn Vliegenthart; Leslee J Shaw; William Stanford; Allen J Taylor; Peter M A van Ooijen; Lewis Wexler; Paolo Raggi Journal: Eur Radiol Date: 2008-07-24 Impact factor: 5.315
Authors: Nicolas Rodondi; Reto Auer; Vanessa de Bosset Sulzer; William A Ghali; Jacques Cornuz Journal: J Gen Intern Med Date: 2011-09-01 Impact factor: 5.128
Authors: Anju Parthan; Kevin J Leahy; Amy K O'Sullivan; Olga A Iakoubova; Lance A Bare; James J Devlin; Milton C Weinstein Journal: Pharmacoeconomics Date: 2013-06 Impact factor: 4.981