Leveraging Incidental CAC on Chest CT Boosts Statin Therapy
A novel quality improvement project that notified physicians and patients about incidental coronary artery calcium (CAC) on prior nongated chest CT scans led to significantly more statin prescriptions than usual care.
Six months after randomization, statins were prescribed to 51.2% of patients who received messages that contained a personalized image of their chest CT with coronary calcium circled in red compared with 6.9% of patients given usual care (P < .001).
Among patients receiving a statin in the notification group, 72.7% received a moderate-intensity statin and 18.2% a high-intensity statin.
“We found opportunistic CAC screening with non-gated chest CT with subsequent clinician and patient notification increases statin initiation rates. This is really important because it leverages existing data without additional radiation at minimal cost,” said study author Alexander Sandhu, MD, MS, Stanford University, California.
He noted that ECG-gated CT scanning, the reference standard for CAC testing, is predictive of cardiovascular outcomes but rarely performed, whereas an estimated 19 million nongated chest CTs are done annually in the United States and also predict cardiovascular events. “This creates an incredible opportunity to extract data on coronary calcium from millions of scans and improve our risk prediction.”