Coronary Artery Calcium Scoring in 2019: Past, Present, and Future

AbstractPurpose of ReviewIn this review, we sought to present a clinically relevant history of coronary artery calcium (CAC) scoring from its initial introduction, to its more recent widespread adoption and guideline endorsement, to future directions of cutting-edge CAC research.Recent FindingsSince prior exhaustive reviews on CAC scoring, the introduction of the Pooled Cohort Equations (PCEs) for the assessment of atherosclerotic cardiovascular disease (ASCVD) risk has been formative in reframing how clinicians discuss risk and prevention with their patients. However, given weaknesses in the performance of the PCEs, additional risk markers have been tested with none being equal to CAC scoring with its ability to reclassify risk. The use of CAC  = 0 as a negative risk factor has proven reliable in diverse populations and has led to increased adoption of CAC scoring by clinical practice guidelines. Newer data explores how CAC scoring can be employed for the quantification of risk in different diseases including modeling the competing ri sks of ASCVD vs. cancer, how CAC can reclassify risk even on non-ECG gated chest computed tomography, and how the algorithm for scoring a CAC scan can be improved in the future.SummaryCAC scoring is a powerful adjunct to the PCEs in further characterizing risk, particularly in borderline to intermediate-risk populations. Newer studies suggest that CAC scoring can be adapted to non-ECG gated chest CTs and that newer CAC scores, which take in...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research