Screening for cardiovascular disease risk using traditional risk factor assessment or coronary artery calcium scoring: the ROBINSCA trial

Carlijn M van der Aalst, Sabine J A M Denissen*, Marleen Vonder, Jan Willem C Gratama, Henk J Adriaansen, Dirkjan Kuijpers, Rozemarijn Vliegenthart, Jeanine E Roeters van Lennep, Pim van der Harst, Richard L Braam, Paul R M van Dijkman, Rykel van Bruggen, Matthijs Oudkerk, Harry J de Koning

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

8 Citaten (Scopus)

Samenvatting

Aim Screening for a high cardiovascular disease (CVD) risk followed by preventive treatment can potentially reduce coronary heart disease-related morbidity and mortality. ROBINSCA (Risk Or Benefit IN Screening for CArdiovascular disease) is a population-based randomized controlled screening trial that investigates the effectiveness of CVD screening in asymptomatic participants using the Systematic COronary Risk Evaluation (SCORE) model or coronary artery calcium (CAC) scoring. This study describes the distributions in risk and treatment in the ROBINSCA trial.

Methods and results Individuals at expected elevated CVD risk were randomized into screening arm A (n = 14 478; SCORE, 10-year fatal and non-fatal risk); or screening arm B (n= 14 450; CAC scoring). Preventive treatment was largely advised according to current Dutch guidelines. Risk and treatment differences between the screening arms were analysed. A total of 12 185 participants (84.2%) in arm A and 12 950 (89.6%) in arm B were screened. In total, 48.7% were women, and median age was 62 (interquartile range 10) years. SCORE screening identified 45.1% at low risk (SCORE <10%), 26.5% at intermediate risk (SCORE 10-20%), and 28.4% at high risk (SCORE >= 20%). According to CAC screening, 76.0% were at low risk (Agatston <100), 15.1% at high risk (Agatston 100-399), and 8.9% at very high risk (Agatston >= 400). CAC scoring significantly reduced the number of individuals indicated for preventive treatment compared to SCORE (relative reduction women: 37.2%; men: 28.8%).

Conclusion We showed that compared to risk stratification based on SCORE, CAC scoring classified significantly fewer men and women at increased risk, and less preventive treatment was indicated.

Originele taal-2English
Pagina's (van-tot)1216-1224
Aantal pagina's9
TijdschriftEuropean heart journal-Cardiovascular imaging
Volume21
Nummer van het tijdschrift11
Vroegere onlinedatum25-jun-2020
DOI's
StatusPublished - 1-nov-2020

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