Study Finds That Seeing Plaque Buildup Prompts Patients To Comply With Medications

Main Category: Compliance
Also Included In: Cholesterol;  Cardiovascular / Cardiology
Article Date: 30 Apr 2006 - 12:00 PST

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A new study has found that seeing the build-up of plaque in their own arteries is the incentive patients need to comply with doctor's orders. The study, conducted at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) and published in the journal Atherosclerosis, found that patients who see more plaque in their arteries (coronary artery calcium) tend to be more likely to stay on statin therapy than those who do not get visual proof of their risk of heart attack.

Cholesterol agents such as statins have been used to reduce cardiac morbidity and mortality, but patients are not inclined to stay on the medication. In most studies, compliance is less than 50 percent after one year.

Authors of the new study found that over a period of 3.6 years, patients who saw visual proof of more plaque after undergoing an electron beam tomography (EBT) scan of their heart were much more likely to comply with prescribed statin therapy. In fact, compliance among those whose scans found the most plaque exceeded 90 percent.

The study followed more than 1,000 patients, each of whom were scanned and then shown their coronary arteries and the plaque that was present.

"Being able to see the buildup of plaque is one of the best and easiest methods to improve patient's compliance, not only with cholesterol medications, but with diet and exercise as well," said Dr. Budoff, a principal investigator at LA BioMed and senior author of the study. "Patients seeing the plaque in their own coronary arteries was a powerful motivator of good behavior persisting over three years."

Electron beam tomography screening is one of the methods of assessing an individual's heart attack risk endorsed by the SHAPE (Screening for Heart Attack Prevention and Education) Task Force, of which Dr. Budoff is a member. This summer, the SHAPE Task Force will publish a new practice guideline for cardiovascular screening in the asymptomatic at-risk population in the American Journal of Cardiology, calling for non-invasive screening of all asymptomatic men 45-75 years and women 55-75 years to assess their coronary plaque volume or carotid wall thickness. The SHAPE Task Force estimates that screening the asymptomatic population will effectively prevent more than 90,000 deaths each year.

"Electron beam tomography identifies heart disease early, which gives us the ability to aggressively care for the disease with treatments that work," said John Duncan, PhD, founder and CEO of ViaScan of Las Colinas. "We can alter the pathway from disease to death. By aggressively intervening, we can save lives."

According to the American Heart Association's 2005 Heart Disease and Stroke Statistics Update, cardiovascular diseases (CVD) accounted for 38 percent of all deaths in the U.S in 2002.

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The Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) is one of the largest independent, not-for-profit biomedical research institutes in Los Angeles County. Affiliated with both the David Geffen School of Medicine at UCLA and the Harbor-UCLA Medical Center, the Institute has an annual budget of over $72 million and currently supports more than 1,000 research studies in areas such as cardiology, emerging infections, cancer, women's health, reproductive health, vaccine research, respiratory physiology, neonatology, molecular biology, and genetics.

Contact: Matthew Budoff, MD,FACC
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed)

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