<p class="MsoNormal"><span lang="EN-GB">Patients from socioeconomically disadvantaged neighborhoods are more likely to have coronary artery calcium (CAC) but less likely to undergo diagnostic scanning for the condition, a large multisite U.S. study found.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">The findings were published Monday online in <i>JACC: Advances</i>, led by Grant Stoltman, BA, from the Minneapolis Heart Institute Foundation. <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">The researchers advocated for the incorporation of CAC scoring into clinical-decision making processes as a well-established, non-invasive clinical tool for cardiovascular risk assessment and a strong independent predictor of future atherosclerotic cardiovascular disease (CVD) events.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">However, they noted that its use depends on access and utilization within health systems, adding that social and environmental conditions contribute "meaningfully" to cardiovascular risk and related <a href="https://journals.lww.com/co-cardiology/abstract/2021/09000/impact_of_social_determinants_of_health_on.11.aspx">inequities</a>. <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">Still, while socioeconomic disadvantage has been "consistently associated with a greater burden of CVD," its relationship with the utilization of cardiovascular preventive imaging remains "poorly understood," they said.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">Stoltman and colleagues therefore set out to define whether socioeconomic factors are associated with differential CAC use via a retrospective cohort analysis of 5,748 individuals undergoing non-contrast computed tomography (CT) for CAC scoring between April 2024 and April 2025 at an out-of-pocket cost of $100 at 8 outpatient imaging sites across a large Midwestern healthcare system.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">They hypothesised that differences in this risk stratification tool could contribute to downstream disparities in CVD prevention and outcomes. <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">At baseline, subjects gad a median age of 60 years and 47.4% were male. Most were Caucasian (94.3%), with other ethnicities including Asian/ Pacific Islander (3.4%), African American (1.4%) and Hispanic (0.9%).<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">The patients' residential addresses and scanner locations were mapped using the Area Deprivation Index (ADI) — a validated, neighborhood-level measure of socioeconomic disadvantage that incorporates income, education, employment and housing quality. They were then grouped into low (scoring 1 to 3 on the ADI), mid (scoring 4 to 6) and high (scoring 7 to 10) levels of socioeconomic disadvantage.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">CAC scan distribution was significantly different across the 3 groups, accounting for 37% of patients in the low ADI cohort, 33.4% in the mid-range and 29.6% in the high tertile (P< 0.001). <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">"Compared to patients with low ADIs, those from high-ADI neighborhoods were under-represented among individuals who underwent CAC scanning," the researchers said.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">Overall, 49.7% of the subjects exhibited prevalent CAC, with the greatest median CAC seen among the high ADI group at 2, compared with zero in both the low and mid-tertiles. <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">In univariable analysis, patients in the high-ADI tertile were more likely to have prevalent CAC compared with those in the low-ADI tertile (odds ratio [OR]: 1.26; 95% confidence interval [CI]: 1.11-1.43; P < 0.001).<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">However, unadjusted association attenuated after adjustment for demographics and clinical risk factors and was no longer statistically significant in the fully adjusted model (OR: 1.11; 95% CI: 0.79-1.56; P = 0.53), the researchers noted. <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">"Disparities in CAC screening in socioeconomically disadvantaged populations may limit opportunities for early detection of subclinical atherosclerosis as well as the timely initiation of evidence-based preventive strategies and therapies," the authors warned.<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">"Without timely risk identification, atherosclerosis may progress undetected and contribute to greater cardiovascular risk over time."<o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB">They pushed for the promotion of equitable access to CAC scanning as an important strategy for population-based CVD prevention strategies. <o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-GB">Sources:<o:p></o:p></span></b></p> <p class="MsoNormal"><span lang="DE-CH" style="mso-ansi-language: DE-CH;">Stoltman G, Benson G, Cichon L, et al. </span><span lang="EN-GB">Coronary Artery Calcium Scans by Area Deprivation Index in a Multicenter Health System. <i>JACC: Advanc</i> 2026; DOI: 10.1016/j.jacadv.2026.102657.<o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-GB">Image Credit: Mulad Images – stock.adobe.com<o:p></o:p></span></b></p>