Author + information
- Received February 20, 2018
- Revision received May 3, 2018
- Accepted May 16, 2018
- Published online July 16, 2018.
- Philip Greenland, MDa,∗ (, )@NUFeinbergMed,
- Michael J. Blaha, MD, MPHb@MichaelJBlaha,
- Matthew J. Budoff, MDc,
- Raimund Erbel, MDd and
- Karol E. Watson, MD, PhDe@kewatson
- aDepartments of Preventive Medicine and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- bCiccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
- cDepartment of Medicine, LA BioMed, Torrance, California
- dInstitute of Medical Informatics, Biometry and Epidemiology, University Clinic, Essen, Germany
- eDepartment of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
- ↵∗Address for correspondence:
Dr. Philip Greenland, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1400, Chicago, Illinois 60611.
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.
- atherosclerotic cardiovascular disease
- coronary artery calcification
- coronary heart disease
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.
- Received February 20, 2018.
- Revision received May 3, 2018.
- Accepted May 16, 2018.
- 2018 American College of Cardiology Foundation
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