Coronary Artery Calcium Score of Patients with an LDL-C > 190 mg/dL and Primary Cardiovascular Disease Prevention Allison Hester, Mary Katherine Cheeley, Terry Jacobson Grady Health System - Atlanta, GA
Background/Purpose: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in developed countries. Using a computed tomography scan to detect coronary artery calcium (CAC) levels is one mechanism of screening for cardiovascular risk. One gap in CAC data is in patients with Familial hypercholesterolemia (FH), a genetic disorder that results in patients having elevated serum cholesterol levels beginning in childhood. Diagnosis of FH can include use of clinical tools such as the Dutch Lipid Criteria. Because patients with confirmed FH have been found to have LDL-C levels of 190 mg/dL or more, any patient who presents with LDL-C of 190 mg/dL or greater is said to express the FH phenotype (regardless of genetic screening). Patients with FH phenotype have an increased risk of ASCVD.
Methodology: Data was collected via retrospective chart review of patients who presented with LDL-C of at least 190 mg/dL and who received a CAC scan. The Dutch Lipid Criteria for diagnosing FH were collected and used to categorize patients into groups of unlikely, possible, probable, and definite FH. CAC scores were compared across groups. Each patient_x0019_s change in risk stratification from before to after the CAC was collected and the mean change in risk was compared across groups.
Presentation Objective: The aim of this presentation is to characterize the CAC scores of patients at Grady Health Services (GHS) with baseline LDL-C > 190 mg/dL, especially with respect to ASCVD risk stratification and to differences in likelihood of FH per the Dutch Lipid Criteria.
Self-Assessment: What does a CAC score tell a provider about a patient_x0019_s risk of ASCVD that an LDL-C level does not? Why would this information be helpful in assessing a patient with FH?
