Coronary artery calcium (CAC) >400 significantly modified the association of baseline statin use and cardiovascular outcomes in patients without cardiovascular disease (CVD), based on findings from the MESA study presented at AHA 2019 and published in JACC: Cardiovascular Imaging. Researchers noted no association of statins and reduction in cardiovascular events in patients with CAC =0 or lower CAC scores, but said this finding should be interpreted with caution.

The multi-center MESA study looked at 6,301 participants between the ages of 45 to 84, without cardiovascular disease between 2000-2002. All participants underwent a CAC test at baseline. At baseline, 938 participants reported statin use and 5,363 did not. The primary outcomes were incident coronary heart disease (CHD) and CVD.

Results showed that over a median follow-up of approximately 14 years, 620 incident CVD and 396 CHD events occurred. The incidence of CVD and CHD were significantly lower in statin users compared with nonusers in the CAC >400 stratum. In contrast, there were no significant differences observed for other strata of CAC ≤400, according to Zhen Zhou, MD, and colleagues. They also noted that restricting the analysis to participants with borderline and higher risk did not significantly change the results.

Additional, larger studies are needed to provide "more reliable" evidence, researchers said.

Clinical Topics: Dyslipidemia, Nonstatins, Novel Agents, Statins

Keywords: AHA19, AHA Annual Scientific Sessions, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Coronary Vessels, Coronary Disease, Calcium, Dietary

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