SHAPE was featured in the latest edition of Cardiovascular Business News in the story, “New CV risk guidelines give SHAPE to imaging screening, not far enough.” The story examines the new ACCF/AHA guidelines for how to assess cardiovascular risk in asymptomatic adults. For the first time, these leading organizations have acknowledged the value of coronary artery calcium (CAC) scoring and carotid artery intima-media thickness (CIMT) scanning by ultrasound. While SHAPE has applauded the new guidelines, we have also urged the organizations to go further.
“Overall, it’s a major change, especially in terms of those at low to intermediate risk who may be suitable to undergo CAC screening,” said PK Shah, MD, chairman of the SHAPE scientific board and director of the Cedars-Sinai Heart Institute and
Medical Center in Los Angeles. “The new guidelines say that CAC scoring and CIMT testing ‘may be reasonable.’ ACC and AHA are clearly conservative and don’t want to go out on a limb. It’s half of an endorsement, but still a major coup and major acknowledgement.”
CAC screening received the strongest recommendation of any of the ancillary tests other than the Framingham risk score, said Matthew J. Budoff, MD, a member of the SHAPE II task force and also the ACCF/AHA writing group, in an interview.
“There is a remarkable amount of evidence that has surfaced since 2005, including seven large, prospective studies that show the presence of calcium has a 10-fold predictive risk for future cardiac events. It outperforms C-reactive protein five times out of five in different clinical trials and it outperforms carotid intima-media thickness in the largest of those studies, MESA, where the predictive value was 10-fold for calcium and only two-fold for carotid ultrasound,” said Budoff, of the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center in Torrance, Calif.
In 2006, SHAPE guidelines called for CAC scoring and CIMT testing to be incorporated into routine screening for all asymptomatic men aged 45 to 75 years and asymptomatic women aged 55 to 75 years. The SHAPE guidelines became the basis for the Texas Heart Attack Prevention Bill, signed into law in Texas in August 2009, which mandates insurance carriers pay for CAC and CIMT testing. The SHAPE II task force is currently meeting to update their guidelines.
To read the full story, visit http://www.healthimaging.com/index.php?option=com_articles&;view=article&id=25278&division=hiit