Cardiac CT in asymptomatic patients at risk

Atherosclerosis is a systemic process that can develop as early as the second or third decade of life. A significant percentage of patients who experience acute coronary syndromes often have non-obstructive coronary artery disease and thus cannot be diagnosed by their symptoms or conventional functional stress testing. It has been proposed that early detection of atherosclerosis would generate novel opportunities for primary prevention through changes in lifestyle or even through drug therapy, especially in patients at high cardiovascular risk. Calcium scoring is a simple, reproducible, and widely available test that has been extensively validated over the past two decades. In this article, the utility of calcium scoring and the potential application of CT coronary angiography in asymptomatic patients at risk are reviewed.