What You Don't Know Might Hurt You
Sometimes despite the best laid business plans, best efforts to identify the potential risks, implementation of all manner of checks and balances, dotting of "i"s and crossing of "t"s, unexpected events can occur where things can go very wrong. The recent grounding of the new A380 Qantas fleet is a case in point. Unheralded events can also impact your health.
For example, do you know what percentage of major cardiovascular events occur without warning? Click here to find out.
How about the percentage of acute coronary events that result from lesions that do not limit blood flow before the event? Click here to find out.
Or the percentage narrowing of your coronary arteries that can occur without you feeling any associated pain? Click here to find out.
The identification of people at risk of a sudden heart attack is critically important as one third of these die prior to reaching hospital and 40% die within the first 12 months. Early identification of risk factors can lead to effective prevention measures that reduce risk and save lives.
Cardiovascular Disease Risk Assessment
The INTERHEART Study demonstrated that 90-95% of the risk of heart attack is related to nine potentially modifiable risk factors (2).
The findings of the INTERHEART study led to the development of risk factor based models used to assess absolute cardiovascular disease risk that classify subjects into low, moderate and high disease risk categories. A substantial number of cardiac events have been shown to occur in the low and moderate risk categories. Click here to find out who should have their cardiovascular disease risk assessed.
CACS Reclassifies Cardiovascular Disease Risk
Coronary Artery Calcium Scoring (CACS) can detect the presence of atherosclerosis in the coronary arteries prior to the onset of symptoms. The coronary arteries are imaged to quantitatively assess coronary calcium, a validated measure of atherosclerotic plaque. Click here to view the coronary calcium levels of two asymptomatic men aged 51 (Panel A) and 81 years (Panel B) (4). The severity of the CAC score for the younger man places him at 85 out of 100 men in his age group whilst the older man's severity of CAC relative to 100 men in his age group places him at 70.
The information gathered from CACS is independent from and additional to the information provided by the cardiovascular disease risk assessment across gender and ethnic groups. Click here to view a graph that shows the increasing risk of a major coronary event with increasing CAC.
A large body of published evidence supports the additional value of CAC screening especially in those at intermediate risk. Click here to view a graph that shows the 7 year rate of major coronary events predicted on the basis of an absolute disease risk assessment protocol and CACS.
CACS - Inclusion is Exclusive to Wesley Corporate Health Executive Assessments
The identification of people in low and moderate risk groups with subclinical atherosclerosis allows improved matching of pharmaceutical or lifestyle intervention to the assessed risk.
Imaging of the subclinical disease can also improve adherence to risk modifying interventions. Studies have shown that the higher the CAC at baseline, the stronger the association with commencement of medical treatment, exercise and dietary modification (1).
At Wesley Corporate Health, our mission is to make a beneficial difference to the lives of everyone of our clients. We use an absolute cardiovascular disease risk assessment approach to expertly assess your cardiovascular disease risk. The exclusive inclusion of the CACS assessment provides you with the most accurate cardiovascular assessment that we believe possible.
- Shah, P.K. MD (2010) Screening Asymptomatic Subjects for Subclinical Atherosclerosis: Can We, Does It Matter and Should We? J Am Coll Cardiol. Vol 56 (2) pp 98-105.
- Yusuf, S. Hawken, S. Ounupu S. et al. (2004) Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (The INTERHEART study). Lancet Vol. 364 pp 937-952.
- D'Agostini Sr RB, Grundy S, Sullivan LM, Wilson P. (2001) Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic group's investigation. JAMA Vol. 286 pp 180-187.
- Bonow R O MD. (2009) Should coronary calcium screening be used in cardiovascular prevention strategies? NEJM Vol. 361 pp 990-997.