title: Subclinical atherosclerosis imaging comes of age:  coronary artery calcium in primary prevention.
abstract: OBJECTIVE
  The goal of this review is to update the contributions of subclinical atherosclerosis imaging of coronary artery calcified plaque (CAC) to the primary prevention of coronary artery disease.
  
  
  RESULTS
  Recent articles have increased support for the following: superiority of CAC determined risk to conventional risk factor-based paradigms, reclassification of risk by CAC, serial CAC scanning to assess the efficacy of therapy, CAC evaluation of high-risk groups (diabetes and other disease states characterized by inflammation), and redefinition of normal and abnormal lipids, ideal treatment goals and residual risk, as well as statin potency.
  
  
  CONCLUSIONS
  The paradigm shifts implicit in the supremacy of CAC herald a transformation in primary prevention from conventional risk factor paradigms to the evaluation of the disease itself by subclinical atherosclerosis imaging.
authors.affiliation: Mount Sinai School of Medicine, New York, New York 10029-6574, USA. harvey.hecht@mountsinai.org
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Hecht
mesh_terms: D019540:Area Under Curve; D050197:Atherosclerosis; D002114:Calcinosis; D003324:Coronary Artery Disease / Q000517:prevention & control; D006801:Humans; D016017:Odds Ratio; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed