title: Coronary computed tomography: current role and future perspectives for cardiovascular risk stratification.
abstract: Coronary artery disease (CAD) is the major cause of morbidity and mortality worldwide. More than 50% of CAD deaths occur in previously asymptomatic individuals at intermediate cardiovascular risk, highlighting the need of more accurate individual risk assessment to decrease cardiovascular events. Cardiac computed tomography (CCT) has emerged as a valuable technique for risk stratification in asymptomatic subjects and in symptomatic patients without known CAD. The absence of coronary artery calcium (CAC) identifies asymptomatic subjects at very low cardiac risk and is reasonable in intermediate risk individuals, in whom CAC measurement reclassifies a substantial number of subjects to different risk categories. In symptomatic patients with suspected CAD, detection of non-obstructive or obstructive CAD by CCT angiography is associated with increased all-cause mortality, and provides incremental risk stratification to CAC. Further studies are needed to assess the impact of CCT on clinical outcomes and its cost-effectiveness in different clinical settings.
authors.affiliation: Department of Internal Medicine, Cardiovascular and Immunological Sciences, Federico II University, Via S Pansini 5, Naples, Italy. fpperron@unina.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Perrone-Filardi
authors.forename: Francesca
authors.initials: F
authors.lastname: Musella
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Savarese
authors.forename: Milena
authors.initials: M
authors.lastname: Cecere
authors.forename: Caterina
authors.initials: C
authors.lastname: Marciano
authors.forename: Oriana
authors.initials: O
authors.lastname: Scala
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rengo
authors.forename: Santo
authors.initials: S
authors.lastname: Dellegrottaglie
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
authors.forename: Dario
authors.initials: D
authors.lastname: Leosco
mesh_terms: D002118:Calcium / Q000378:metabolism; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000378:metabolism; D006801:Humans; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D002118:Calcium