How a single question improves the effectiveness of CAC scanning
Asking older patients one simple question when they undergo coronary artery calcium (CAC) scanning can make a world of difference, according to new findings published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes.
The question—“one a scale of 1 to 10, how much do you exercise?”—takes just a moment to ask, but researchers found it can help specialists make much more accurate assessments when it comes to a patient’s mortality risk.
The study’s authors tracked data from more than 2,000 patients between the ages of 65 and 84 years old. All patients underwent CAC screening from August 1998 to November 2016 and died more than one year after the screening occurred. The questionnaire given to these patients covered topics such as chest pain symptoms and medication use, and the question about self-reporting physical activity was also included.
Lead author Alan Rozanski, MD, of the Icahn School of Medicine at Mount Sinai, and colleagues followed these older patients for an average of 10.6 years. Overall, 23% of patients had died by that time, translating to an annualized mortality rate of 2.3% pear year.
The team noted that the mortality was highest (2.9% per year) among patients who reported low physical activity—and lowest (1.7% per year) for those who reported high physical activity.
Among patients with low CAC scores, the survival was similar for all physical activity levels. Among patients with moderate CAC scores, however, the risk for all-cause mortality jumped significantly if a patient reported low physical activity. When patients had a high CAC score (more than 400), the risk for all-cause mortality increased 2.35-folder for patients with low physical activity.
“Our results indicate that a simple assessment of self-reported daily-life physical activity can substantially improve the effectiveness of CAC scanning for risk stratifying older adults and is strongly encouraged,” Rozanski said in a statement. “This is consistent with recent suggestions to make assessment of physical activity a 'fifth vital sign' that should be entered into patient electronic medical records, along with body temperature, pulse rate, respiration rate, and blood pressure.”
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.