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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and

Mark J Pletcher1, Jeffrey A Tice, Michael Pignone

  • 1Department of Epidemiology and Biostatistics, University of California, San Francisco, 500 Parnassus Ave, MU 420 West, Box 0560, San Francisco, CA 94143, USA. mpletcher@epi.ucsf.edu

Archives of Internal Medicine
|July 1, 2004
PubMed

Insights

The coronary artery calcium score independently predicts coronary heart disease events. This measurement improves risk assessment for primary prevention in high-risk patients.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Medical Imaging

Background:

  • Primary prevention of coronary heart disease (CHD) is crucial for high-risk individuals.
  • Coronary artery calcium (CAC) scoring is a proposed method to enhance risk assessment.
  • The added predictive value of CAC scoring beyond standard risk factors was previously unclear.

Purpose of the Study:

  • To determine if coronary artery calcium (CAC) scoring provides independent predictive information for coronary heart disease (CHD) events.
  • To evaluate the utility of CAC scoring in risk stratification for primary prevention.

Main Methods:

  • Systematic literature search of studies published between 1980 and 2003.
  • Inclusion of studies measuring CAC score via electron beam computed tomography in asymptomatic subjects with subsequent CHD event follow-up.
  • Meta-analysis of adjusted relative risks for different CAC score categories using a random-effects model.

Main Results:

  • Meta-analysis of 4 studies showed an adjusted relative risk of 2.1 (95% CI, 1.6-2.9) for a CAC score of 1-100 compared to 0.
  • Higher CAC scores (101-400 and >400) demonstrated progressively higher relative risks, ranging from 3.0 to 17.0.
  • Significant heterogeneity among studies was observed, potentially explained by differences in outcome adjudication, risk factor assessment, and technical parameters.

Conclusions:

  • The coronary artery calcium score is an independent predictor of coronary heart disease events.
  • CAC scoring offers valuable information for refining risk assessment in asymptomatic individuals.
  • Further research may clarify the impact of study variations on CAC score predictive accuracy.
Abstract

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