{
  "abstract": "Study objective\n\nTo evaluate the impact of coronary artery calcium (CAC) scoring on lipid-lowering therapy intensification, aspirin initiation, and downstream cardiac testing in primary prevention patients in a community cardiology setting.Design\n\nRetrospective observational study.Setting\n\nSingle community cardiology practice.Participants\n\nFour hundred consecutive patients undergoing CAC scoring in 2022.Interventions\n\nCAC scoring used for risk stratification and clinical decision-making.Main outcome measures\n\nChanges in lipid-lowering therapy, aspirin initiation, and downstream cardiac testing across CAC categories (0, 1-99, 100-399, ≥400); risk reclassification using Pooled Cohort Equations (PCE) and Multi-Ethnic Study of Atherosclerosis (MESA) risk scores.Results\n\nAmong 400 patients (mean age 60.2 ± 10.6 years; 46.5% male), 30% had CAC = 0, 37% CAC 1-99, 18% CAC 100-399, and 16% CAC ≥400. Lipid therapy modification increased across categories (7.7%, 33.3%, 69.0%, 81.7%; p < 0.001), as did aspirin initiation among aspirin-naive patients (1.0%, 8.0%, 51.9%, 52.5%; p < 0.001) and stress testing (2.7%, 6.5%, 29.0%, 68.6%; p < 0.001). Each one-category CAC increment was independently associated with lipid therapy modification (adjusted OR 4.36, 95% CI 3.13-6.06), aspirin initiation (OR 4.48, 95% CI 2.85-7.03), and stress testing (OR 5.11, 95% CI 3.33-7.84; all p < 0.001). CAC changed MESA risk category in 192/348 patients (55.2%): 87 upward and 105 downward.Conclusions\n\nCAC burden was independently associated with graded intensification of lipid-lowering therapy, aspirin initiation, and downstream testing after multivariable adjustment, extending prior descriptive literature with persistent, quantified associations in real-world community practice. Improvement in clinical outcomes cannot be assessed from this retrospective, six-month implementation study.",
  "abstract_shown": true,
  "affiliations": [
    "Hospital of the University of Pennsylvania, Philadelphia, PA, USA.",
    "University of Vermont, Burlington, VT, USA.",
    "Cardiology Consultants of Philadelphia, Philadelphia, PA, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fahdem Iamrl"
    },
    {
      "affs": [
        1
      ],
      "name": "Matthew Sangoi"
    },
    {
      "affs": [
        0
      ],
      "name": "Douglas Jacoby"
    },
    {
      "affs": [
        0
      ],
      "name": "Daniel E Soffer"
    },
    {
      "affs": [
        2
      ],
      "name": "Colin Movsowitz"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dpfv0t58mebta.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ahjo.2026.100938",
  "fulltext_url": "https://europepmc.org/articles/PMC13677183",
  "id": "dpfv0t58mebta",
  "issns": [
    "2666-6022"
  ],
  "landing_url": "https://europepmc.org/article/MED/42894852",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2741|Cardiac Imaging and Diagnostics"
    ]
  ],
  "openalex": "W7220732993",
  "pdf_url": "https://europepmc.org/articles/PMC13677183?pdf=render",
  "pmcid": "PMC13677183",
  "pmid": "42894852",
  "published": "2026-10-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dpfv0t58mebta.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:37Z",
      "native_id": "MED:42894852",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42894852"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2741|Cardiac Imaging and Diagnostics",
      "subfield": "imaging"
    }
  ],
  "title": "Real-world impact of coronary artery calcium scoring on primary prevention management in a community cardiology practice.",
  "title_text": "Real-world impact of coronary artery calcium scoring on primary prevention management in a community cardiology practice.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:37Z",
  "url": "https://research.draconitic.com/paper/dpfv0t58mebta",
  "venue": "American heart journal plus : cardiology research and practice",
  "versions": []
}