title: An Update on the Utility of Coronary Artery Calcium Scoring for Coronary Heart Disease and Cardiovascular Disease Risk Prediction.
abstract: Estimating cardiovascular disease (CVD) risk is necessary for determining the potential net benefit of primary prevention pharmacotherapy. Risk estimation relying exclusively on traditional CVD risk factors may misclassify risk, resulting in both undertreatment and overtreatment. Coronary artery calcium (CAC) scoring personalizes risk prediction through direct visualization of calcified coronary atherosclerotic plaques and provides improved accuracy for coronary heart disease (CHD) or CVD risk estimation. In this review, we discuss the most recent studies on CAC, which unlike historical studies, focus sharply on clinical application. We describe the MESA CHD risk calculator, a recently developed CAC-based 10-year CHD risk estimator, which can help guide preventive therapy allocation by better identifying both high- and low-risk individuals. In closing, we discuss calcium density, regional distribution of CAC, and extra-coronary calcification, which represent the future of CAC and CVD risk assessment research and may lead to further improvements in risk prediction.
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA.
authors.forename: Sina
authors.initials: S
authors.lastname: Kianoush
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Al Rifai
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA.|Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, 21287, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Cainzos-Achirica
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA.
authors.forename: Priya
authors.initials: P
authors.lastname: Umapathi
authors.affiliation: Aetna Foundation, Hartford, CT, USA.|University of Connecticut School of Medicine, Farmington, CT, USA.
authors.forename: Garth
authors.initials: G
authors.lastname: Graham
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA.|Center for Healthcare Advancement and Outcomes & Miami Cardiac and Vascular Institute, Baptist Health South Florida, Miami, FL, USA.|Department of Epidemiology, Robert Stempel College of Public Health, Miami, FL, USA.|Department of Medicine, Herbert Wertheim College of Medicine, Miami, FL, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.affiliation: Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, 21287, USA. mblaha1@jhmi.edu.|Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, 21287, USA. mblaha1@jhmi.edu.|, Blalock 524 D1, 600 N. Wolfe St., Baltimore, MD, 21287, USA. mblaha1@jhmi.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Blaha
mesh_terms: D002114:Calcinosis; D002118:Calcium / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D006801:Humans; D011322:Primary Prevention; D012307:Risk Factors
chemical_list: D002118:Calcium
keywords: Cardiovascular disease; Coronary artery calcium; Coronary heart disease; Primary prevention; Risk assessment; Statins