Self- vs provider-referral differences for coronary artery calcium testing
Study objectives: The objectives of this study were to identify independent predictors for moderate/accentuated coronary artery calcium (CAC) score and compare patients who self-referred for CAC Computed Tomography (CT) testing to those who were provider-referred. Design: Patients underwent CAC betw...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-01-01
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| Series: | American Heart Journal Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602222000052 |
| _version_ | 1818022282844438528 |
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| author | Rebekah Lantz Steve Young Janet Lubov Anas Ahmed Ronald Markert Srikanth Sadhu |
| author_facet | Rebekah Lantz Steve Young Janet Lubov Anas Ahmed Ronald Markert Srikanth Sadhu |
| author_sort | Rebekah Lantz |
| collection | DOAJ |
| description | Study objectives: The objectives of this study were to identify independent predictors for moderate/accentuated coronary artery calcium (CAC) score and compare patients who self-referred for CAC Computed Tomography (CT) testing to those who were provider-referred. Design: Patients underwent CAC between January to July 2019. The analysis was divided into self-referred patients influenced by a CAC community campaign who identified themselves as having cardiovascular risk factors compared to provider-referred intermediate-risk patients who were asymptomatic. SAS version 9.4 (SAS Institute, Inc., Cary, NC) was used for all analyses. Setting: Seven southwest Ohio hospitals from a single network. Participants: 2124 adult patients who received CAC CT (163 self and 1961 provider-referred). Interventions: CAC CT. Main outcome measures: Demographics, risk factors, lab values, prescriptions, and referral status were used to compare CAC score differences between self- and provider-referred patients. Results: For 2124 patients, three predictors for moderate/accentuated CAC score remained significant after multiple logistic regression: CKD (OR 0.24, CI 0.008–0.68, p < 0.05), COPD (OR 0.39, CI 0.19–0.80, p < 0.05), and CAD (OR 0.46, CI 0.22–0.98, p < 0.05). There were four differences between referred groups: history of PVD (OR 0.21, CI 0.05–0.86, p < 0.05), higher triglyceride (OR 1.004, CI 1.00–1.01, p < 0.05), higher LDL levels (OR 0.991, CI 0.98–1.00, p < 0.05), and beta blocker prescription (OR 4.38, CI 1.49–12.85, p < 0.05) in self-referred patients. Conclusions: CAC CT testing is associated with independent risk predictors and can be used to clarify cardiovascular risk in self- and provider-referred patients with statistical similarity. Patients reliably self-refer for CAC CT when risk is present during a community initiative. Such initiatives may have a preventive benefit and lead to earlier pursuit and optimization of anti-lipid therapies. |
| first_indexed | 2024-04-14T08:29:25Z |
| format | Article |
| id | doaj.art-c480b5e1787848b399cbde9968fd314c |
| institution | Directory Open Access Journal |
| issn | 2666-6022 |
| language | English |
| last_indexed | 2024-04-14T08:29:25Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj.art-c480b5e1787848b399cbde9968fd314c2022-12-22T02:03:57ZengElsevierAmerican Heart Journal Plus2666-60222022-01-0113100088Self- vs provider-referral differences for coronary artery calcium testingRebekah Lantz0Steve Young1Janet Lubov2Anas Ahmed3Ronald Markert4Srikanth Sadhu5Wright State University Boonshoft School of Medicine, Internal Medicine Residency, Dayton, OH 45409, United States of America; Corresponding author at: 4424 Appleton Place, Dayton, OH 45409, United States of America.Wright State University Boonshoft School of Medicine, Internal Medicine Residency, Dayton, OH 45409, United States of AmericaWright State University Boonshoft School of Medicine, Fairborn, OH 45324, United States of AmericaWright State University Boonshoft School of Medicine, Internal Medicine Residency, Dayton, OH 45409, United States of AmericaWright State University Boonshoft School of Medicine, Department of Internal Medicine and Neurology, Fairborn, OH 45324, United States of AmericaPremier Cardiovascular Institute, Interventional Cardiology, Premier Health, Dayton, OH 45409, United States of AmericaStudy objectives: The objectives of this study were to identify independent predictors for moderate/accentuated coronary artery calcium (CAC) score and compare patients who self-referred for CAC Computed Tomography (CT) testing to those who were provider-referred. Design: Patients underwent CAC between January to July 2019. The analysis was divided into self-referred patients influenced by a CAC community campaign who identified themselves as having cardiovascular risk factors compared to provider-referred intermediate-risk patients who were asymptomatic. SAS version 9.4 (SAS Institute, Inc., Cary, NC) was used for all analyses. Setting: Seven southwest Ohio hospitals from a single network. Participants: 2124 adult patients who received CAC CT (163 self and 1961 provider-referred). Interventions: CAC CT. Main outcome measures: Demographics, risk factors, lab values, prescriptions, and referral status were used to compare CAC score differences between self- and provider-referred patients. Results: For 2124 patients, three predictors for moderate/accentuated CAC score remained significant after multiple logistic regression: CKD (OR 0.24, CI 0.008–0.68, p < 0.05), COPD (OR 0.39, CI 0.19–0.80, p < 0.05), and CAD (OR 0.46, CI 0.22–0.98, p < 0.05). There were four differences between referred groups: history of PVD (OR 0.21, CI 0.05–0.86, p < 0.05), higher triglyceride (OR 1.004, CI 1.00–1.01, p < 0.05), higher LDL levels (OR 0.991, CI 0.98–1.00, p < 0.05), and beta blocker prescription (OR 4.38, CI 1.49–12.85, p < 0.05) in self-referred patients. Conclusions: CAC CT testing is associated with independent risk predictors and can be used to clarify cardiovascular risk in self- and provider-referred patients with statistical similarity. Patients reliably self-refer for CAC CT when risk is present during a community initiative. Such initiatives may have a preventive benefit and lead to earlier pursuit and optimization of anti-lipid therapies.http://www.sciencedirect.com/science/article/pii/S2666602222000052CoronaryCalcificationStatinHyperlipidemiaCACASCVD |
| spellingShingle | Rebekah Lantz Steve Young Janet Lubov Anas Ahmed Ronald Markert Srikanth Sadhu Self- vs provider-referral differences for coronary artery calcium testing American Heart Journal Plus Coronary Calcification Statin Hyperlipidemia CAC ASCVD |
| title | Self- vs provider-referral differences for coronary artery calcium testing |
| title_full | Self- vs provider-referral differences for coronary artery calcium testing |
| title_fullStr | Self- vs provider-referral differences for coronary artery calcium testing |
| title_full_unstemmed | Self- vs provider-referral differences for coronary artery calcium testing |
| title_short | Self- vs provider-referral differences for coronary artery calcium testing |
| title_sort | self vs provider referral differences for coronary artery calcium testing |
| topic | Coronary Calcification Statin Hyperlipidemia CAC ASCVD |
| url | http://www.sciencedirect.com/science/article/pii/S2666602222000052 |
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