Personalizing cardiovascular risk: Coronary artery calcium scans to improve statin use in adults with type 2 diabetes can be cost‐effective in select individuals

Abstract

BACKGROUNDMany adults with diabetes are not on a statin. 1 A coronary artery calcium (CAC) scan provides a depiction of coronary artery disease and is predictive of cardiovascular (CV) risk. Showing and discussing CAC scan findings with patients has been shown to increase the use of preventive medications. 2,3 Even in trials where CAC-based intervention reduced the use of statins (e.g., due to enrolment of healthier individuals at lower CV risk), the distribution of statin use shifted toward higher-risk individuals, 4 with overall reductions in CV risk. 2 CAC scans may be considered a form of personalized medicine, with incremental utility dependent on judicious patient selection. 5,6 Guidelines recommend the use of CAC scans in intermediate-risk individuals to help decide whether to start statin therapy. Since