High cholesterol, high blood pressure, diabetes, and smoking are well-known risks for heart disease, but not everyone who has a heart attack has these risks. In fact, previous studies have shown that 14% to 27% of heart attack patients have none of these risk factors.
Now, a new study by researchers at Intermountain Health in Salt Lake City has found that these patients had something in common. All of them tended to have high coronary artery calcium levels.
Results of a new Intermountain study detect this type of plaque buildup even in the absence of four standard modifiable risk factors so that it can be diagnosed and treated before these patients receive their first treatment. This indicates that scanning should be considered as part of standard treatment. A heart attack event occurs.
“Measuring coronary artery calcium can have a major impact on how we identify who is at risk for heart disease,” said Jeffrey, lead author of the study and research physician at Intermountain Health.・L. Anderson said. “There are risk factors that we don’t yet recognize or understand that are responsible for the increased risk of heart attack in these patients, so we need to go beyond the four major risk factors that are modifiable.”
The results of this study will be presented at the American Heart Association Scientific Sessions 2023 in Philadelphia on November 11, 2023.
In the study, Intermountain researchers identified 429 heart attack patients who also underwent coronary artery calcium scans. Of these, 369 had standard modifiable risk factors (SMuRF), including diagnosis and treatment of hypertension, hyperlipidemia, diabetes, and smoking. 60 was not (without SMuRF).
The researchers looked at these patients’ calcium artery scan scores, as well as major adverse cardiovascular events such as another heart attack, stroke, or death at 60 days and over the long term.
The researchers found that patients without SMuRF had higher rates and percentiles of coronary artery calcium scores. He also found that 77% of these patients met criteria for preventive therapy, such as statins or aspirin. As expected, SMuRF patients’ CAC scores and percentiles were also higher. Outcomes were overall better in patients without SMuRF and in patients with lower coronary artery calcium scores.
Coronary artery calcium scans are becoming more common and affordable, but are still not part of the guideline-based standard of care.
“Because we’re still relying only on standard risk factors, we’re missing about a quarter of people at risk of heart attack,” Dr. Anderson said. “We do not scan low-risk patients who do not have these common risk factors, but given our findings, we hope to identify and treat these seemingly low-risk patients. We may need to change it to be able to provide a preventive therapy.”
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A new study by researchers at Intermountain Health finds that these patients have one thing in common. That is, all of them tend to have high coronary artery calcium levels.