title: An evidence-based guide for coronary calcium scoring in asymptomatic patients without coronary heart disease.
abstract: As public awareness and clinical use of CAC screening increases, physicians should, at a minimum, know the following information: 1) The presence of CAC indicates underlying CHD but does not predict luminal obstruction. 2) Non-contrast, prospectively ECG-gated cardiac EBCT and MDCT are sensitive, reproducible, rapid, and essentially equivalent imaging techniques commonly used to screen for CAC. 3) Currently, CAC screening is appropriate for all intermediate- risk patients and low-risk patients with a family history of premature CHD, and might be appropriate for all low-risk women. 4) The risks associated with CAC screening are a small but measurable excess risk of cancer and the risk of unnecessary downstream tests and procedures. 5) A CAC score of zero has a very high negative predictive value for CHD events. 6) Increasingly positive (non-zero) CAC scores are directly proportional to increased CHD event risk, and a CAC score >100 or greater than the 75th percentile indicates high risk. 7) Repeat screening to determine CAC progression or regression is not currently recommended.
authors: Center for Women's Heart & Vascular Health, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors: Nishant R
authors: NR
authors: Shah
authors: Stephanie A
authors: SA
authors: Coulter
mesh_terms: D058070:Asymptomatic Diseases; D017023:Coronary Angiography / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000191:economics; D019317:Evidence-Based Medicine; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography / Q000009:adverse effects / Q000191:economics; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D011829:Radiation Dosage; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000191:economics; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000191:economics