Current Cardiology Reports

, 20:10 | Cite as

Coronary Artery Calcium Scoring in Young Adults: Evidence and Challenges

  • Marwan Saad
  • Naga Venkata Pothineni
  • Joseph Thomas
  • Richa Parikh
  • Swathi Kovelamudi
  • Dina Elsayed
  • Ramez Nairooz
  • Frederick Feit
Ischemic Heart Disease (D Mukherjee, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Ischemic Heart Disease


Purpose of Review

This review aims to summarize the evidence and challenges of coronary artery calcium (CAC) scoring as a screening tool for coronary artery disease (CAD) in young adults.

Recent Findings

Several cohort studies have highlighted the value of CAC scoring in CAD risk assessment in young adults. The largest study to date is the Coronary Artery Risk Development in Young Adults (CARDIA) study. The study examined patients at 18–30 years of age and demonstrated that the presence of any degree of CAC was associated with a higher risk of coronary events compared to zero CAC, with an incremental increase in the risk of events with higher scores. However, it is important to note that 70% of patients screened had CAC = 0 at the age of 56.


Despite the evidence that higher CAC score cutoff used in guidelines for predicting cardiovascular risk may be “falsely reassuring,” however, mass screening of young adults using CAC score may be challenging. The development of prediction tools and scoring systems to identify patients at higher risk of developing CAC based on known CAD risk factors may help reduce the number needed to screen to detect patients with positive CAC.


Coronary Calcium score Young adults Age Review 



Atherosclerotic cardiovascular disease


Coronary artery calcium


Coronary artery disease


Coronary heart disease


Compliance with Ethical Standards

Conflict of Interest

Marwan Saad MD, Naga Venkata Pothineni, Joseph Thomas, Richa Parikh, Swathi Kovelamudi, Dina Elsayed, Ramez Nairooz, and Frederick Feit declare that they have no conflict of interest.

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.


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Marwan Saad
    • 1
    • 2
  • Naga Venkata Pothineni
    • 1
  • Joseph Thomas
    • 3
  • Richa Parikh
    • 3
  • Swathi Kovelamudi
    • 3
  • Dina Elsayed
    • 4
  • Ramez Nairooz
    • 5
  • Frederick Feit
    • 6
  1. 1.Division of Cardiovascular MedicineUniversity of Arkansas for Medical SciencesLittle RockUSA
  2. 2.Division of CardiologyAin Shams UniversityCairoEgypt
  3. 3.Department of MedicineUniversity of Arkansas for Medical SciencesLittle RockUSA
  4. 4.Division of Biomedical Informatics, Graduate SchoolUniversity of Arkansas for Medical SciencesLittle RockUSA
  5. 5.Division of Cardiovascular MedicineUniversity of South CaliforniaLos AngelesUSA
  6. 6.Division of Cardiovascular MedicineNew York University School of MedicineNew YorkUSA

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