Coronary Artery Calcium Screening —Data First

Screening tests are examinations performed on asymptomatic individuals to diagnose life-threatening medical conditions early enough to intervene to reduce disease-specific and overall mortality. Although the benefits of finding an unrecognized disease early in its course seem intuitive, screening tests and the clinical decisions based on them require testing with randomized clinical trials (RCTs) to understand the magnitude of benefit (if any) and the potential for harms including radiation, psychological stress, and unnecessary downstream testing and treatment with additional costs and potential complications. Coronary artery calcium scanning (CACS), a screening test introduced in 1990 to reduce mortality from coronary artery disease (CAD), has never been evaluated in an RCT designed and powered to assess its effect on CAD or all-cause mortality. Nevertheless, the Society of Cardiac Computed Tomography and the National Lipid Association (NLA) not only recommend the use of CACS to screen intermediate-risk asymptomatic individuals, but also provide recommendations for statin and aspirin therapy based on the results. In addition, the NLA advocates for the use of CACS to screen selected groups who already qualify for lipid lowering therapy (those with diabetes and familial hypercholesterolemia) to guide decisions around intensity, without evidence of improved outcomes.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research