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Coronary Artery Calcium Scoring: a Valuable Aid in Shared Decision Making Among Non-traditional Risk Markers

  • Cardiac Computed Tomography (T Villines, Section Editor)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

The purpose of this study was to evaluate the utility of coronary artery calcium (CAC) scoring and compare it with other non-traditional cardiovascular risk markers for improvement in cardiovascular risk assessment.

Recent Findings

CAC scoring refines risk assessment among asymptomatic patients eligible for primary prevention across the spectrum of cardiovascular risk. Its use has been well-validated in several multi-ethnic population-based cohorts. With the recent ACC/AHA cholesterol treatment guidelines expanding the eligibility for statin therapy for primary prevention, the absence of CAC can be a powerful tool for identifying those at lower risk of future cardiovascular events. CAC is superior to other non-traditional risk markers recognized by the current risk assessment guidelines for re-classifying patients to appropriate risk categories and improving discrimination of risk beyond traditional risk factors.

Summary

CAC scoring is a reliable decision-making tool for improving cardiovascular risk assessment and performs better than other non-traditional risk markers, particularly when used to identify those at lower risk (i.e., CAC = 0).

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Abbreviations

ABI:

ankle-brachial index

ACC:

American College of Cardiology

AHA:

American Heart Association

ASCVD:

atherosclerotic cardiovascular disease

CAC:

coronary artery calcium

CARDIA:

Coronary Artery Risk Development in Young Adults

CHD:

coronary heart disease

CVD:

cardiovascular disease

CIMT:

carotid intima-media thickness

DHS:

Dallas Heart Study

EBCT:

electron-beam computed tomography

FHS:

Framingham Heart Study

HNR:

Heinz-Nixdorf Recall

hsCRP:

high sensitivity C-reactive protein

LDL-C:

low density lipoprotein cholesterol

MDCT:

multi-detector computed tomography

MESA:

Multi-Ethnic Study of Atherosclerosis

MI:

myocardial infarction

PCE:

pooled cohort equations

TRF:

traditional risk factors

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Compliance with Ethics Guidelines

Conflict of Interest

Anurag Mehta, Joseph Miller III, and Parag H. Joshi declare that they have no conflict of interest.

Michael J. Blaha reports grants and personal fees from the FDA, grants from NIH/NHLBI, grants from AHA, personal fees from ACC, grants from Aetna Foundation, grants and personal fees from Amgen/Amgen Foundation, personal fees from Novartis, personal fees from MedImmune, personal fees from Sanofi/Regeneron, and personal fees from Akcea, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA

    Anurag Mehta

  2. Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Michael J. Blaha & Parag H. Joshi

  3. Piedmont Heart Institute, Atlanta, GA, USA

    Joseph Miller III

  4. Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, E5.730F, Dallas, TX, 75390-8830, USA

    Parag H. Joshi

Authors
  1. Anurag Mehta
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  2. Michael J. Blaha
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  4. Parag H. Joshi
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Correspondence to Parag H. Joshi.

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This article is part of Topical Collection on Cardiac Computed Tomography

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Mehta, A., Blaha, M.J., Miller, J. et al. Coronary Artery Calcium Scoring: a Valuable Aid in Shared Decision Making Among Non-traditional Risk Markers. Curr Cardiovasc Imaging Rep 10, 33 (2017). https://doi.org/10.1007/s12410-017-9431-3

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  • DOI: https://doi.org/10.1007/s12410-017-9431-3

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