Visualizing coronary calcium is associated with improvements in adherence to statin therapy

Atherosclerosis. 2006 Apr;185(2):394-9. doi: 10.1016/j.atherosclerosis.2005.06.018. Epub 2005 Jul 26.


Background: Many patients lack motivation to control cardiovascular risk factors and clinicians have long sought ways to activate apathetic patients. Despite significant and consistent data on the benefits of lipid-lowering agents to reduce cardiovascular events, adherence and utilization of these agents remains low. We evaluated whether visualization of coronary calcium would positively affect patients' adherence rates.

Methods: We evaluated patients who underwent electron beam tomography (EBT) coronary calcium evaluation at least 1 year prior with a survey questioning them about health behaviors. Patients filled out baseline and follow-up questionnaires relating to lifestyle modifications, including statin utilization, diet, exercise, tobacco cessation and vitamin/antioxidant utilization.

Results: The study population consisted of 505 individuals on statin therapy on baseline who were followed for a mean of 3 +/- 2 years. Overall the statin compliance was lowest (44%) among those with CAC score in the first quartile (0-30), whereas 91% of individuals with baseline CAC score in the fourth quartile (>or= 526) adhered to statin therapy. In multivariable analysis, after adjusting for cardiovascular risk factors, age, and gender, higher baseline CAC scores were strongly associated with adherence to statin therapy.

Conclusions: In addition to risk stratification for the asymptomatic person, patients visualizing coronary artery calcium may improve utilization and adherence to lipid-lowering therapy. Outcome studies and randomized trials need to be done to quantify the true value and cost-effectiveness of this approach.

MeSH terms

  • Calcinosis / diagnostic imaging*
  • Coronary Angiography*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / psychology
  • Coronary Vessels*
  • Female
  • Health Behavior
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Male
  • Middle Aged
  • Patient Compliance*
  • Patient Education as Topic
  • Risk Factors
  • Tomography, X-Ray Computed


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors