title: The Implication of Coronary Artery Calcium Testing for Cardiovascular Disease Prevention and Diabetes.
abstract: Over the last two decades coronary artery calcium (CAC) scanning has emerged as a quick, safe, and inexpensive method to detect the presence of coronary atherosclerosis. Data from multiple studies has shown that compared to individuals who do not have any coronary calcifications, those with severe calcifications (i.e., CAC score >300) have a 10-fold increase in their risk of coronary heart disease events and cardiovascular disease. Conversely, those that have a CAC of 0 have a very low event rate (~0.1%/year), with data that now extends to 15 years in some studies. Thus, the most notable implication of identifying CAC in individuals who do not have known cardiovascular disease is that it allows targeting of more aggressive therapies to those who have the highest risk of having future events. Such identification of risk is especially important for individuals who are not on any therapies for coronary heart disease, or when intensification of treatment is being considered but has an uncertain role. This review will highlight some of the recent data on CAC testing, while focusing on the implications of those findings on patient management. The evolving role of CAC in patients with diabetes will also be highlighted.
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rblankstein@partners.org.
authors.forename: Ron
authors.initials: R
authors.lastname: Blankstein
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.|Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Ankur
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Division of Cardiology, Kaiser Permanente Northern California, Oakland, CA, USA.|Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
authors.forename: Jamal S
authors.initials: JS
authors.lastname: Rana
authors.affiliation: Department of Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.|Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, FL, USA.
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
keywords: Atherosclerosis; Coronary artery disease; Diabetes; Prevention and control