Computed tomographic cardiovascular imaging

Area of Science:

• Cardiology
• Preventive Medicine
• Medical Imaging

Background:

• Atherosclerosis imaging is crucial for identifying patients at high risk for cardiac events.
• Electron beam computed tomography and carotid intimal media thickness have advanced understanding of preclinical atherosclerosis.
• Elevated calcium scores predict future cardiac events, independently and incrementally to traditional risk factors.

Purpose of the Study:

• To review the value of coronary artery calcium (CAC) screening in asymptomatic and symptomatic patients.
• To highlight how accurate measurement of subclinical coronary atherosclerosis improves cardiovascular risk prediction.
• To demonstrate CAC's role in tracking atherosclerosis burden and predicting future events.

Main Methods:

• Review of current understanding and data on coronary artery calcium screening.
• Analysis of the predictive power of elevated calcium scores.
• Discussion of the cost-effectiveness of screening intermediate-risk patients.

Main Results:

• Elevated calcium scores (e.g., >100) show a 10-fold predictive power for future cardiac events.
• CAC screening significantly improves the accuracy of global cardiovascular risk prediction.
• Screening intermediate-risk patients is suggested to be most cost-effective.

Conclusions:

• CAC screening aids in identifying high-risk patients who may benefit from further testing and intensified medical therapy.
• CAC has a significant impact on the early detection and management of coronary artery disease (CAD).
• Guidelines and policies increasingly recognize the importance of atherosclerosis imaging modalities.