Coronary Calcium Score and Cardiovascular Risk

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

doi:10.1016/j.jacc.2018.05.027

Coronary Calcium Score and Cardiovascular Risk

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

^*Corresponding author for this work

Preventive Medicine

Research output: Contribution to journal › Review article › peer-review

587 Scopus citations

Abstract

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 language	English (US)
Pages (from-to)	434-447
Number of pages	14
Journal	Journal of the American College of Cardiology
Volume	72
Issue number	4
DOIs	https://doi.org/10.1016/j.jacc.2018.05.027
State	Published - Jul 24 2018

Funding

The Heinz Nixdorf Recall Study was funded by the Heinz Nixdorf Foundation, the German Aero-Space Center (Deutsches Zentrum für Luft- und Raumfahrt), and the German Research Council Assessment. The MESA study was supported by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences. Dr. Blaha has received grant funding from the Aetna Foundation and the Amgen Foundation. Dr. Budoff has received funding from the National Institutes of Health and GE. Dr. Blaha is a member of the advisory boards of MedImmune, Akcea, Novartis, Amgen, Sanofi, and Regeneron. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Keywords

aspirin
atherosclerotic cardiovascular disease
coronary artery calcification
coronary heart disease
statins

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jacc.2018.05.027

Cite this

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title = "Coronary Calcium Score and Cardiovascular Risk",

abstract = "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.",

keywords = "aspirin, atherosclerotic cardiovascular disease, coronary artery calcification, coronary heart disease, statins",

author = "Philip Greenland and Blaha, {Michael J.} and Budoff, {Matthew J.} and Raimund Erbel and Watson, {Karol E.}",

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AU - Greenland, Philip

AU - Blaha, Michael J.

AU - Budoff, Matthew J.

AU - Erbel, Raimund

AU - Watson, Karol E.

PY - 2018/7/24

Y1 - 2018/7/24

N2 - 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.

AB - 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.

KW - aspirin

KW - atherosclerotic cardiovascular disease

KW - coronary artery calcification

KW - coronary heart disease

KW - statins

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Coronary Calcium Score and Cardiovascular Risk

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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