- In older patients, a coronary artery calcium (CAC) score of 0 or ≤10, low galectin-3, or absence of carotid plaques mark low atherosclerotic cardiovascular disease (CVD) risk.
Why this matters
- Despite stark increases in CVD risk with age and conventional wisdom that statins apply to almost every elderly patient, some people in this age group may still have low risk.
- These patients may not need to be folded into the “treat-all approach” typically applied in this population, say the authors.
- With CAC of 0 or ≤10, diagnostic likelihood ratios (DLRs) were both 0.20 for coronary heart disease (CHD).
- They also were associated, respectively, with DLRs of 0.41 and 0.48 for CVD.
- Galectin-3 was also associated with derisking: with values th percentile, DLRs for CHD and CVD were 0.44 and 0.43, respectively.
- No carotid plaque was associated with DLRs of 0.39 and 0.65, respectively, for CHD and CVD.
- Biomarkers showing no derisking association included no family history of CVD, normal ankle-brachial index.
- Evaluation of 13 possible CVD biomarkers in 5805 BioImage study participants (mean age, 69 years; median follow-up, 2.7 years).
- Funding: Multiple industry funders.
- Event rates lower than anticipated.