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Atlas of Cardiovascular Computed Tomography pp 49–67Cite as

Coronary Artery Calcium in Primary Prevention

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Abstract

Without question, CAC scanning is one of the most important diagnostic achievements in the primary prevention of coronary heart disease in the past generation. Every study, whether retrospective, self-referred, or based on a prospective population, has consistently and conclusively shown CAC to be the most powerful predictor of risk in asymptomatic patients, outperforming carotid intima media thickness, brachial artery reactivity, ankle brachial index, and serum biomarkers, including C-reactive protein. It consistently adds incremental and independent predictive value to risk calculators (ie- Framingham Risk or Pooled Risk Cohort) for future ASCVD events. CAC has a strong influence to improving adherence to statin medications, aspirin, diet, and exercise programs. This has been consistently demonstrated, with greater adherence reflecting higher CAC scores. Finally, non-coronary calcifications (ie – thoracic aorta and valve calcification) have been demonstrated to add important prognostic and diagnostic information related to the cardiac patient. Thus, coronary artery calcium is a robust, easy to perform, low radiation test, that is increasingly being used as a screening test in asymptomatic persons to identify those with advanced atherosclerosis who would benefit from preventive therapies.

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Authors and Affiliations

  1. Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Harvey S. Hecht MD

  2. UCLA, Los Angeles Biomedical Research Institute, 1124 W Carson Street, Torrance, CA, 90502, USA

    Matthew J. Budoff MD

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  1. Harvey S. Hecht MD
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Correspondence to Matthew J. Budoff MD .

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Editors and Affiliations

  1. Los Angeles Biomedical Research Institute, UCLA, Torrance, California, USA

    Matthew J. Budoff

  2. Department of Cardiology, Universitätsklinikum Erlangen, Erlangen, Germany

    Stephan S. Achenbach

  3. Mount Sinai Hospital, New York City, New York, USA

    Harvey S. Hecht

  4. Department of Cardiology , Mount Sinai Hospital, New York, New York, USA

    Jagat Narula

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Hecht, H.S., Budoff, M.J. (2018). Coronary Artery Calcium in Primary Prevention. In: Budoff, M., Achenbach, S., Hecht, H., Narula, J. (eds) Atlas of Cardiovascular Computed Tomography. Springer, London. https://doi.org/10.1007/978-1-4471-7357-1_4

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