TITLE:
Prevention of Coronary Heart Disease: A Translational Clinical Challenge
AUTHORS:
Julie Giannini, Janae Padilla, Robert Philip Eaton, Kristen Gonzales, David S. Schade
KEYWORDS:
Asymptomatic Cardiovascular Disease, Coronary Artery Calcium Scan, Preventive Medical Therapy, Cardiovascular Risk
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.12 No.1,
January
21,
2022
ABSTRACT: Introduction: Atherosclerotic cardiovascular disease is a dysmetabolic medical condition resulting in the #1 cause of morbidity and mortality in theUnitedStates. Coronary Artery Calcium (CAC) CT non-invasively identifies atherosclerosis in asymptomatic individuals. This translational study tested the hypothesis that clinically overtcardiovascular disease can be prevented in asymptomatic individuals in a medical clinic. Methods: Two hundred and six asymptomatic adults requested a CAC scan to identify subclinical heart disease. Individuals with a positive CAC score > 1 (n = 125) were prescribed targeted medical therapy to reverse their atherosclerosis. The goal was to achievean LDL Cholesterol (LDL-C) ≤ 60 mg/dl. One hundred and ten individuals reached thisgoal (67 male, 43 female) receiving 10 mg/d of rosuvastatin and 10 mg/d ofezetimibe plus a low cholesterol diet. Other fifteen individuals with positive CAC scores did not achieve this LDL-C goal. Results: In the group following medical therapy and achieving an LDL-C ≤ 60 mg/dl, no cardiovascular events were observed during a maximum observation period of 5 years (mean observation time = 3.6 years). Based on previously published CVD outcome data in individuals with similar CAC scores, 12.6 cardiovascular events were expected.Two of fifteen individuals with positive CAC scores not following medicaltherapy had a cardiovascular event. None of the 81 individuals with a zero score hada cardiovascular event during follow-up. No adverse effects of therapy occurred. Conclusion: In a medical clinic, adult population with positive CAC scores and an LDL-C ≤ 60 mg/dl, targeted medical therapy prevented overt cardiovasculardisease. These results should encourage other physicians to aggressively treat atherosclerotic cardiovascular disease in their clinic populations.