Core Concepts
Coronary artery calcium score is a superior predictor of coronary heart disease events compared to the polygenic risk score.
Abstract
The study compared the predictive utility of coronary artery calcium (CAC) score and polygenic risk score in identifying individuals at risk for coronary heart disease (CHD). Here are the key highlights and insights from the content:
CAC score on computed tomography showed better risk discrimination for CHD events than the polygenic risk score.
The study involved middle-aged and older White adults from the U.S. and the Netherlands.
Direct visualization of calcification in arteries by CAC score may explain its superiority over genetic variants.
Traditional risk factors, CAC score, and polygenic risk score were used to calculate CHD risk.
Both scores were significantly associated with the 10-year risk of incident CHD.
The CAC score had a higher C statistic compared to the polygenic risk score, indicating better risk discrimination.
Net reclassification significantly improved with CAC plus pooled cohort equations, while the polygenic risk score did not show significant improvement.
The use of CT imaging in patients at intermediate risk for heart disease can refine risk estimation and guide therapy recommendations.
Stats
The CAC score had a C statistic of 0.76 (95% CI, 0.71-0.79) vs. 0.69 for the polygenic risk score (95% CI, 0.63-0.71).
Net reclassification significantly improved with the CAC plus PCEs by the following values: 0.19 (95% CI, 0.06-0.28).
Quotes
"The use of CT in patients who are at intermediate risk for heart disease can be helpful in refining risk estimation and guiding recommendations for lipid-lowering therapy." - Dr. Kahn