Implications of Coronary Artery Calcium Testing among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines MESA (Multi-Ethnic Study of Atherosclerosis)

Khurram Nasir, Marcio S. Bittencourt, Michael J. Blaha, Ron Blankstein, Arthur S. Agatson, Juan J. Rivera, Michael D. Miemdema, Christopher Sibley, Leslee J. Shaw, Roger S. Blumenthal, Matthew J. Budoff, Harlan M. Krumholz

Research output: Contribution to journalArticle

206 Scopus citations


Background The American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol management guidelines have significantly broadened the scope of candidates eligible for statin therapy. Objectives This study evaluated the implications of the absence of coronary artery calcium (CAC) in reclassifying patients from a risk stratum in which statins are recommended to one in which they are not. Methods MESA (Multi-Ethnic Study of Atherosclerosis) is a longitudinal study of 6,814 men and women 45 to 84 years of age without clinical atherosclerotic cardiovascular disease (ASCVD) risk at enrollment. We excluded 1,100 participants (16%) on lipid-lowering medication, 87 (1.3%) without low-density lipoprotein levels, 26 (0.4%) with missing risk factors for calculation of 10-year risk of ASCVD, 633 (9%) >75 years of age, and 209 (3%) with low-density lipoprotein

Original languageEnglish (US)
Pages (from-to)1657-1668
Number of pages12
JournalJournal of the American College of Cardiology
Issue number15
Publication statusPublished - Oct 13 2015



  • atherosclerosis
  • cholesterol
  • hydroxymethylglutaryl-CoA reductase inhibitors
  • risk assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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