Coronary artery calcium scoring in the age of CT angiography: what is its role?
It has become commonplace to try to gear the intensity of preventive measures to the degree of risk. It is, however, problematic to merely use traditional risk factors to gauge risk in the individual patient because the tools currently in use are based on population estimates and they may not directly apply to the individual being assessed. Indeed, it is not unusual for patients at low to intermediate risk to suffer unexpected events, whereas some high-risk patients appear unusually healthy. Imaging for atherosclerosis may offer an alternative to this approach. Often, there is a large discrepancy between the burden of atherosclerosis estimated with coronary artery calcium or intima-media thickness and the risk of future cardiovascular events estimated with the Framingham risk score. This may justify some of the clinical discrepancy. Here, we review the current evidence surrounding the use of coronary artery calcium for risk prediction.
Raggi
Paolo
P
Emory University School of Medicine, 1365 Clifton Road, NE, AT-504, Atlanta, GA 30322, USA. praggi@emory.edu
Khan
Akbar
A
Arepali
Chesnal
C
Stillman
Arthur E
AE
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D002118:Calcium / Q000032:analysis*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000208:ethnology; D003331:Coronary Vessels / Q000737:chemistry* / Q000473:pathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods*; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
D002118:Calcium