Covered a VERY recent study in my #LowCarbBreck talk last week. Kind of shocking really. CAC is an incredible test for middle-aged middle-risk people, the group where most heart attacks occur. Now there is a rather deceitful and misleading argument against CAC - that it may give "false negatives" for younger people (i.e. show a low score but they still have significant danger). There are so many reasons why this is essentially misleading, and statistically not so relevant - but here are a couple:
1. Overwhelmingly, heart attacks occur in middle-aged or older people. The younger people are a tiny fraction of the actual problem (not that they aren't important mind). This argument is used to push back against CAC generally. Naughty.
2. The "false negatives" are from people who got a low score yet went on to have an event a few years later (I still haven't got this data but that's what "they" say). However, younger people whose diabetic fires are blazing will need more regular scans if they don't fix the underlying problem. Example: They get a zero/low CAC at say, year zero. They would have had a higher score at say, year one (but didn't get a scan - oops). Then they have an event at say, year two. This isn't an argument against CAC - it's just an unreasonable demand placed upon the technology !
Anyway, now to the paper. Looks like the argument is more misleading than I thought. See slide below - the CAC is massively predictive for younger people - even with lowish "risk factors" present ! Just look at the predictive power here using a CAC scan - absolutely amazing - nothing comes close. Why am I not surprised?
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