The DanCavas Pilot Study of Multifaceted Screening for Subclinical Cardiovascular Disease in Men and Women Aged 65–74 Years. (January 2017)

• Record Type: Journal Article
• Authors: Kvist, T.V.; Lindholt, J.S.; Rasmussen, L.M.; Søgaard, R.; Lambrechtsen, J.; Steffensen, F.H.; Frost, L.; Olsen, M.H.; Mickley, H.; Hallas, J.; Urbonaviciene, G.; Busk, M.; Egstrup, K.; Diederichsen, A.C.P.
• Is Part Of: European journal of vascular and endovascular surgery. Volume 53:Number 1(2017)
• Page Start: 123
• Page End: 131
• Publication Date: 2017-01
• Subjects: Aortic aneurysm -- Cardiovascular prevention -- Computed tomography -- Coronary calcium score -- Peripheral arterial disease -- Screening; Blood-vessels -- Endoscopic surgery -- Periodicals; Blood-vessels -- Surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Vascular Surgical Procedures -- methods -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; Blood-vessels -- Endoscopic surgery; Blood-vessels -- Surgery; Endoscopy; Electronic journals; Periodicals; Electronic journals; 617.413005
• DOI: 10.1016/j.ejvs.2016.10.010
• Languages: English
• ISSNs: 1078-5884

Abstract

Abstract : Objective/Background: This pilot study of a large population based randomised screening trial investigated feasibility, acceptability, and relevance (prevalence of clinical and subclinical cardiovascular disease [CVD] and proportion receiving insufficient prevention) of a multifaceted screening for CVD. Methods: In total, 2060 randomly selected Danish men and women aged 65–74 years were offered (i) low dose non-contrast computed tomography to detect coronary artery calcification (CAC) and aortic/iliac aneurysms; (ii) detection of atrial fibrillation (AF); (iii) brachial and ankle blood pressure measurements; and (iv) blood levels of cholesterol and hemoglobin A1c. Web based self booking and data management was used to reduce the administrative burden. Results: Attendance rates were 64.9% ( n = 678) and 63.0% ( n = 640) for men and women, respectively. In total, 39.7% received a recommendation for medical preventive actions. Prevalence of aneurysms was 12.4% (95% confidence interval [CI] 9.9–14.9) in men and 1.1% (95% CI 0.3–1.9) in women, respectively ( p < .001). A CAC score > 400 was found in 37.8% of men and 11.3% of women ( p < .001), along with a significant increase in median CAC score with age ( p = .03). Peripheral arterial disease was more prevalent in men (18.8%, 95% CI 15.8–21.8) than in women (11.2%, 95% CI 8.7–13.6). No significant differences between the sexes were found with regard to newly discovered AF (men 1.3%, women 0.5%), potential hypertension (men 9.7%, women 11.5%), hypercholesterolemia (men 0.9%, women 1.1%) or diabetes mellitus (men 2.1%, women 1.3%). Conclusion: Owing to the higher prevalence of severe conditions, such as aneurysms and CAC ≥ 400, screening for CVD seemed more prudent in men than women. The attendance rates were acceptable compared with other screening programs and the logistical structure of the screening program proved successful.