title: Visualization of Coronary Artery Calcification: Influence on Risk Modification.
abstract: OBJECTIVE
  Direct health provider to patient presentation of coronary computed tomography angiography findings may increase adherence to preventive therapy and risk modification. The purpose of this study was to assess the influence of visualization of coronary artery calcification and lifestyle recommendations on cholesterol concentrations and other risk variables in symptomatic patients with nonobstructive coronary artery disease and hyperlipidemia.
  
  
  METHODS
  We performed a prospective 2-center randomized controlled trial. Patients were randomized 1:1 to intervention or standard follow-up in general practice. The primary end point was change in plasma total cholesterol concentration at 6 months follow-up.
  
  
  RESULTS
  We included 189 patients (mean [± standard deviation] age 61 [12] years, 57% were male). Median (range) Agatston score was 166 (70-2054). The reduction in plasma total cholesterol concentrations tended to be higher in the intervention group than in the control group, 51.04 mg/dL versus 45.63 mg/dL (P = .181). In a subgroup including patients continuing statin therapy during follow-up (n = 147), the reduction in plasma total cholesterol concentrations was more pronounced in the intervention group than in the control group, 66.13 mg/dL versus 55.68 mg/dL (P = .027). In the intervention group, there was a higher degree of statin adherence and a higher proportion of patients who stopped smoking and commenced healthier dietary behavior than in the control group.
  
  
  CONCLUSIONS
  Visualization of coronary artery calcification and brief recommendations about risk modification after coronary computed tomography angiography in symptomatic patients with nonobstructive coronary artery disease and hyperlipidemia may have a favorable influence on plasma total cholesterol concentration, adherence to statin therapy, and risk behavior. Further investigations are needed.
authors.affiliation: Department of Cardiology, Lillebaelt Hospital-Vejle, Vejle, Denmark.
authors.forename: Rikke E
authors.initials: RE
authors.lastname: Mols
authors.affiliation: Department of Cardiology, Aarhus University Hospital-Skejby, Aarhus, Denmark.
authors.forename: Jesper M
authors.initials: JM
authors.lastname: Jensen
authors.affiliation: Department of Cardiology, Hospital of South West Denmark-Esbjerg and The Regional Unit of Health Research, University of Southern Denmark, Esbjerg, Denmark.
authors.forename: Niels Peter
authors.initials: NP
authors.lastname: Sand
authors.affiliation: Department of Cardiology, Aarhus University Hospital-Skejby, Aarhus, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Fuglesang
authors.affiliation: Department of Cardiology, Hospital of South West Denmark-Esbjerg and The Regional Unit of Health Research, University of Southern Denmark, Esbjerg, Denmark.
authors.forename: Døne
authors.initials: D
authors.lastname: Bagdat
authors.affiliation: Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Vedsted
authors.affiliation: Department of Cardiology, Aarhus University Hospital-Skejby, Aarhus, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Bøtker
authors.affiliation: Department of Cardiology, Lillebaelt Hospital-Vejle, Vejle, Denmark.
authors.forename: Lene H
authors.initials: LH
authors.lastname: Nielsen
authors.affiliation: Department of Cardiology, Aarhus University Hospital-Skejby, Aarhus, Denmark. Electronic address: bnorgaard@dadlnet.dk.
authors.forename: Bjarne L
authors.initials: BL
authors.lastname: Nørgaard
mesh_terms: D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000517:prevention & control; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000517:prevention & control; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Adherence preventive therapy; Angina pectoris; Atherosclerosis; Coronary artery calcification; Lifestyle behavior; Risk factor modification