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What is the role of calcium scoring in the age of coronary computed tomographic angiography?

  • Advances in Nonnuclear Imaging Technologies
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Non-contrast-enhanced CT for coronary artery calcification (CAC) as a marker of coronary atherosclerosis has been studied extensively in the primary prevention setting. With rapidly evolving multidetector CT technology, contrast-enhanced coronary CT angiography (CCTA) has emerged as the non-invasive method of choice for detailed imaging of the coronary tree. In this review, we systematically evaluate the role of CAC testing in the age of CCTA in both asymptomatic and symptomatic patients, across varying levels of risk. Although the role of CAC testing is well established in asymptomatic subjects, its use in evaluating those with stable symptoms that represent possible obstructive coronary artery disease is controversial. Nevertheless, available data suggest that in low-to-intermediate risk symptomatic patients, CAC scanning may serve as an appropriate gatekeeper to further testing with either CCTA (if no or only mild CAC present) versus functional imaging or invasive coronary angiography (when moderate or severe CAC present). Given the strong short-term prognostic value of CAC = 0, studies are needed to further evaluate the role of CAC scanning in low-risk patients with acute chest pain presenting to the emergency room.

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Authors and Affiliations

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

    Parag H. Joshi MD, Michael J. Blaha MD, MHS, Roger S. Blumenthal MD & Khurram Nasir MD, MPH

  2. Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women’s Hospital, Boston, MA, USA

    Ron Blankstein MD

  3. Baptist Health South Florida, 1691 Michigan Avenue, Suite 500, Miami Beach, FL, 33139, USA

    Khurram Nasir MD, MPH

Authors
  1. Parag H. Joshi MD
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  2. Michael J. Blaha MD, MHS
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  3. Roger S. Blumenthal MD
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  4. Ron Blankstein MD
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  5. Khurram Nasir MD, MPH
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Correspondence to Khurram Nasir MD, MPH.

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Joshi, P.H., Blaha, M.J., Blumenthal, R.S. et al. What is the role of calcium scoring in the age of coronary computed tomographic angiography?. J. Nucl. Cardiol. 19, 1226–1235 (2012). https://doi.org/10.1007/s12350-012-9626-6

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  • DOI: https://doi.org/10.1007/s12350-012-9626-6

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