Coronary Calcium Score and Cardiovascular Risk

Philip Greenland*, Michael J. Blaha, Matthew J. Budoff, Raimund Erbel, Karol E. Watson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

377 Scopus citations


Coronary artery calcium (CAC) is a highly specific feature of coronary atherosclerosis. On the basis of single-center and multicenter clinical and population-based studies with short-term and long-term outcomes data (up to 15-year follow-up), CAC scoring has emerged as a widely available, consistent, and reproducible means of assessing risk for major cardiovascular outcomes, especially useful in asymptomatic people for planning primary prevention interventions such as statins and aspirin. CAC testing in asymptomatic populations is cost effective across a broad range of baseline risk. This review summarizes evidence concerning CAC, including its pathobiology, modalities for detection, predictive role, use in prediction scoring algorithms, CAC progression, evidence that CAC changes the clinical approach to the patient and patient behavior, novel applications of CAC, future directions in scoring CAC scans, and new CAC guidelines.

Original languageEnglish (US)
Pages (from-to)434-447
Number of pages14
JournalJournal of the American College of Cardiology
Issue number4
StatePublished - Jul 24 2018


  • aspirin
  • atherosclerotic cardiovascular disease
  • coronary artery calcification
  • coronary heart disease
  • statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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