Table 4.
CAC score. Prognosis and recommended treatment strategies.*
| CAC score = 0 | CAC score 1-100 | CAC score > 100 | ||
|---|---|---|---|---|
| Population (% patients)(28) | 56% | 26% | 18% | |
| Annual frequency of events(29) | 0.1% | 0.5% | 1.9% | |
| Annual frequency of cardiovascular events(28) | 0.4% | 0.8% | 2.4% | |
| Number needed to treat (to prevent one cardiovascular event over a five year period) | ||||
| Treatment with aspirin - Number needed to treat(28) | FRS < 10% | 2036 | 571* | 173 |
| 808 | 146* | 92 | ||
| Treatment with statins - Number needed to treat(30) | FRS ≥ 10% | 549 | 94 | 24 |
| Treatment recommendations | ||||
| CAC score = 0 | CAC score 1-100 | CAC score > 100 | ||
| Recommended | None | Tailored use of statins + aspirin | Statins + aspirin | |
| Recommendation for all patients | Life style change + monitoring of cardiovascular risk factors | |||
*
The estimated number needed to produce damage from aspirin use (one episode of major bleeding over the five year period) is 442 patients(28). Therefore, when the anticipated benefit exceeds the risk (e.g., when the FRS is ≥ 10% in patients with a calcium score of 1-100), the use of aspirin should be considered. CAC score (Agatston method). FRS, Framingham risk score.