CAC found to be best predictor of heart disease.

HealthDay (8/22, Gordon) reports on two studies published in the Aug. 22/29 issue of the Journal of the American Medical Association comparing different means of predicting heart disease. The first study compared "coronary artery calcium scans [CAC], ankle-brachial index, high-sensitivity C-reactive protein (CRP), family history, carotid intima-media thickness and brachial flow-mediated dilation," and lead author Dr. Joseph Yeboah, assistant professor of cardiology at Wake Forest Baptist Medical Center in Winston-Salem, NC said that the coronary artery calcium scan was "far superior to all of the other top-tier markers we studied." The other study was based on "data from 14 studies involving nearly 46,000 participants and found that the carotid intima-media thickness test was associated with a small improvement in heart disease prediction, but that the improvement was so small it's likely not to be helpful in clinical practice."

        WebMD (8/22, Boyles) reports that the first "study included about 1,300 people with heart disease risk factors (except diabetes) who were determined to have an intermediate risk for developing heart disease, based on the widely used prediction model known as the Framingham Risk Score (FRS)." Then "after having all six of the tests, they were followed for an average of" 7.5 years.

        MedPage Today (8/22, Phend) reports, "The group pointed out that cost and radiation exposure from coronary artery calcium testing have to be assessed before making broad recommendations about incorporating it into primary prevention screening strategies." Also CAC is "unlikely to be useful for tracking risk over time to look for a worsening trend." The story notes that "the American College of Cardiology and American Heart Association have given family history a class I recommendation for use as an add-on to Framingham risk calculation, while carotid intima-media thickness, coronary artery calcium, ankle-brachial index, and high-sensitivity CRP (hsCRP) received class II recommendations. They recommended against brachial flow-mediated dilation."