Coronary artery calcium score: Re-evaluation of its predictive value for coronary artery disease

Coronary artery disease is the leading cause of death in advanced countries and its prevalence is increasing among the developing countries. Cardiac computed tomography (CT) has been increasingly used in the diagnosis of coronary artery disease due to its rapid improvements in multislice CT scanners over the last decade, and this less-invasive technique has become a potentially effective alternative to invasive coronary angiography. Quantifying the amount of coronary artery calcium with cardiac CT has been widely accepted as a reliable non-invasive technique for predicting risk of future cardiovascular events. However, the main question that remains uncertain is whether routine, widespread coronary artery calcium scoring in an individual patient will result in an overall improvement in quality of care and clinical outcomes. In this commentary, we discuss a current issue of the clinical value of coronary artery calcium scoring with regard to its value of predicting adverse cardiac events. We also discuss the applications of coronary artery calcium scores in patients with different risk groups.