Simple questionnaire spots patients with ‘silent’ CAD who may benefit from follow-up cardiac imaging

A simple screening questionnaire can spot patients at risk of developing coronary artery disease, helping clinicians determine who would most benefit from a follow-up imaging exam to further assess plaque buildup.

Researchers with Sweden’s Gothenburg University presented findings from the CArdioPulmonary BioImage Study on Friday, during the American Heart Association’s virtual meeting.

"The buildup of plaque does not cause symptoms in the early phases of atherosclerosis yet may lead to reduced blood flow to the heart and result in a heart attack," Göran Bergström, MD, PhD, lead physician at the university’s Sahlgrenska Academy, said in a statement. “We investigated whether a personalized screening strategy using data easily measured at home could predict which patients are at high risk of developing heart disease."

For their investigation, the team analyzed more than 30,000 individuals—between 50 and 64 years old—with no history of heart attack or cardiac intervention. Participants were asked health questions regarding their gender, age, smoking history, body measurements, cholesterol medication, and blood pressure to assess CAD risk.  

Bergström et al. then used coronary computed tomography angiography (CCTA) to assess patients’ for signs of plaque buildup. Of the more than 25,000 to receive an exam, 42% had plaque in their coronary arteries, with rates highest among men and older participants.

The authors said they were “surprised” that atherosclerosis was so prevalent and easily predicted using a basic questionnaire. And though early detection of CAD can be done via CCTA imaging, the technique can be expensive.

"Our study lays the foundation for development of a home-based screening strategy to help combat cardiovascular disease,” the authors concluded. “We can find people at high risk of having silent coronary artery disease using a simple screening questionnaire followed by a clinical visit to a healthcare facility to define the risk further using CCTA imaging."