0:03
Hi, I'm Melissa Axelrod. I'm a fellow at Columbia University and I'm going to be talking about abstract 0922 presented by Landon and his colleagues, which was examining the coronary artery calcification in patients with lupus classified as low cardiovascular risk by the new PREVENT calculator.
0:23
So the question here is simple but clinically important.
0:25
When our patients have a low calculated cardiovascular risk, do we just forget about it and be reassured?
0:32
So the 2026 ACC guidelines recommend the PREVENT calculator to estimate future atherosclerotic cardiovascular events.
0:42
Lupus is recognized in and of itself as a cardiovascular risk factor enhancing condition, but it isn't directly incorporated into the equation.
0:52
And as rheumatologists, we know that chronic inflammation, accumulated organ damage, and treatment exposure may contribute to cardiovascular risk beyond traditional risk factors.
1:03
The investigators studied 83 women ages 40 to 60 without known cardiovascular disease at a tertiary lupus center in Brazil.
1:13
And here's what the headline found. 60 patients were categorized as low risk, meaning a predicted 10-year ASCVD risk score less than 3%.
1:23
12 of those 60, which is about one fifth, had detectable coronary artery calcium scores.
1:30
So they would have been ignored on a PREVENT score, and yet when we looked at the imaging, it showed that they were finding coronary calcifications.
1:41
So what do we think this tells us? It tells us to keep looking and not just ignore a low PREVENT score.
1:49
Most importantly, PREVENT predicts cardiovascular events while the study measured coronary calcium at a single point in time.
1:58
So does this mean we should order coronary calcium scans for every lupus patient with a low PREVENT score?
2:06
Not necessarily. But also what I think was interesting is it started for patients aged 40 to 60, and that's forgetting about the 30-year-olds.
2:14
My biggest takeaway is that a low calculated cardiovascular risk does not necessarily mean an absence of coronary atherosclerosis in lupus.
2:22
So we have some next steps to take, and we'll see a bit more at the next conference.
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