To the Editor: Improving our understanding of the place of computed tomography (CT) coronary calcium scoring in the assessment of cardiovascular disease risk is critical. However, we disagree with the conclusions in the article by Venkataraman and colleagues1 that the results of their study support the use of CT coronary calcium scoring in individuals with intermediate risk using the Australian cardiovascular disease risk (ACVDR) calculator. Unfortunately, the study has significant flaws in its outcome measures — CT coronary artery calcium scoring and Multi‐Ethnic Study of Atherosclerosis (MESA) — which result in misleading conclusions.
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- 1. Venkataraman P, Stanton T, Liew D, et al. Coronary artery calcium scoring in cardiovascular risk assessment of people with family histories of early onset coronary artery disease. Med J Aust 2020; 213: 170–177. https://www.mja.com.au/journal/2020/213/4/coronary-artery-calcium-scoring-cardiovascular-risk-assessment-people-family
- 2. Albarqouni L, Doust JA, Magliano D, et al. External validation and comparison of four cardiovascular risk prediction models with data from the Australian Diabetes, Obesity and Lifestyle study. Med J Aust 2019; 210: 161–167. https://www.mja.com.au/journal/2019/210/4/external-validation-and-comparison-four-cardiovascular-risk-prediction-models
- 3. US Preventive Services Task Force; Curry SJ, Krist AH, Owens DK, et al. screening for cardiovascular disease risk with electrocardiography: US Preventive Services Task Force recommendation statement. JAMA 2018; 319: 2308–2314.
- 4. Mandrola J, Foy A. The Case against coronary artery calcium scoring for cardiovascular disease risk assessment. Am Fam Physician 2019; 100: 734–735.
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