Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?

Quantification of coronary artery calcium (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk. Formal CAC scoring was introduced in 1990, with early scoring algorithms notable for their simplicity and elegance. Yet, with little evidence available on how to best b...

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Veröffentlicht in:JACC. Cardiovascular imaging Jg. 10; H. 8; S. 923
Hauptverfasser: Blaha, Michael J, Mortensen, Martin Bødtker, Kianoush, Sina, Tota-Maharaj, Rajesh, Cainzos-Achirica, Miguel
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.08.2017
Schlagworte:
Algorithms
Computed Tomography Angiography
Coronary Angiography - methods
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - epidemiology
Coronary Vessels - diagnostic imaging
Decision Support Techniques
Humans
Multidetector Computed Tomography
Predictive Value of Tests
Prognosis
Reproducibility of Results
Severity of Illness Index
Vascular Calcification - diagnostic imaging
Vascular Calcification - epidemiology
prediction
cardiovascular disease
score
risk
coronary artery calcium
cardiac CT
ISSN:1876-7591, 1876-7591
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Zusammenfassung:Quantification of coronary artery calcium (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk. Formal CAC scoring was introduced in 1990, with early scoring algorithms notable for their simplicity and elegance. Yet, with little evidence available on how to best build a score, and without a conceptual model guiding score development, these scores were, to a large degree, arbitrary. In this review, we describe the traditional approaches for clinical CAC scoring, noting their strengths, weaknesses, and limitations. We then discuss a conceptual model for developing an improved CAC score, reviewing the evidence supporting approaches most likely to lead to meaningful score improvement (for example, accounting for CAC density and regional distribution). After discussing the potential implementation of an improved score in clinical practice, we follow with a discussion of the future of CAC scoring, asking the central question: do we really need a new CAC score?
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
ObjectType-Review-3
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ISSN:1876-7591
1876-7591
DOI:10.1016/j.jcmg.2017.05.007