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J Am Coll Cardiol. 2018 Jul 24;72(4):434-447. doi: 10.1016/j.jacc.2018.05.027.

Coronary Calcium Score and Cardiovascular Risk.

Author information

1
Departments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: p-greenland@northwestern.edu.
2
Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland. Electronic address: https://twitter.com/MichaelJBlaha.
3
Department of Medicine, LA BioMed, Torrance, California.
4
Institute of Medical Informatics, Biometry and Epidemiology, University Clinic, Essen, Germany.
5
Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: https://twitter.com/kewatson.

Abstract

Coronary artery calcium (CAC) is a highly specific feature of coronary atherosclerosis. On the basis of single-center and multicenter clinical and population-based studies with short-term and long-term outcomes data (up to 15-year follow-up), CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin. CAC testing in asymptomatic populations is cost effective across a broad range of baseline risk. This review summarizes evidence concerning CAC, including its pathobiology, modalities for detection, predictive role, use in prediction scoring algorithms, CAC progression, evidence that CAC changes the clinical approach to the patient and patient behavior, novel applications of CAC, future directions in scoring CAC scans, and new CAC guidelines.

KEYWORDS:

aspirin; atherosclerotic cardiovascular disease; coronary artery calcification; coronary heart disease; statins

PMID:
30025580
PMCID:
PMC6056023
[Available on 2019-07-24]
DOI:
10.1016/j.jacc.2018.05.027
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