title: The Heinz Nixdorf Recall study and its potential impact on the adoption of atherosclerosis imaging in European primary prevention guidelines.
abstract: Non-contrast-enhanced computed tomography (CT) imaging of the heart enables noninvasive quantification of coronary artery calcification (CAC), a surrogate marker of the atherosclerotic burden in the coronary artery tree. Multiple studies have underlined the ability of CAC score for individual risk stratification and, accordingly, the American Heart Association recommended cardiac CT for risk assessment in individuals with an intermediate risk of cardiovascular events as measured by Framingham Risk Score. However, limitations in transcribing risk stratification algorithms based on American cohort studies into European populations have been acknowledged in the past. Moreover, data on implications for reclassification into higher- or lower-risk groups based on CAC scores were lacking. The Heinz Nixdorf Recall (HNR) study is a population-based cohort study that investigated the ability of CAC scoring in risk prediction for major cardiovascular events above and beyond traditional cardiovascular risk factors. According to Heinz Nixdorf Recall findings, CAC can be used for reclassification, especially in those in the intermediate-risk group, to advise on lifestyle changes for the reclassified low-risk category, or to implement intensive treatments for the reclassified high-risk individuals. This article discusses the present findings of the Heinz Nixdorf Recall Study with respect to the current literature, risk stratification algorithms, and current European guidelines for risk prediction.
authors.affiliation: Department of Cardiology, West-German Heart Center Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Mahabadi
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.forename: Hagen
authors.initials: H
authors.lastname: Kälsch
authors.forename: Marcus
authors.initials: M
authors.lastname: Bauer
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000368:Aged; D000465:Algorithms; D002114:Calcinosis / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed