Use of coronary artery calcium score and coronary CT angiography to guide cardiovascular prevention and treatment

Area of Science:

• Cardiovascular imaging
• Preventive cardiology
• Radiology

Background:

• Current cardiovascular risk stratification relies on clinical scores with modest discriminative power.
• Coronary artery calcium score (CACS) and coronary CT angiography (CCTA) are emerging as advanced risk assessment tools.
• Personalized treatment strategies are needed to improve cardiovascular event prevention.

Purpose of the Study:

• To review the evidence for CACS and CCTA in guiding preventive therapies.
• To explore the role of plaque burden and phenotype in monitoring treatment response.
• To enhance cardiovascular risk prediction and personalize patient management.

Main Methods:

• Review of current scientific literature on CACS and CCTA applications.
• Analysis of studies evaluating risk prediction accuracy of imaging biomarkers.
• Discussion of plaque quantification and characterization for therapeutic monitoring.

Main Results:

• CACS enhances cardiovascular risk prediction and optimizes statin therapy in primary prevention.
• CACS may identify patients benefiting from antiplatelet therapy.
• CCTA provides detailed plaque information for guiding and monitoring anti-atherosclerotic treatments.

Conclusions:

• CACS and CCTA significantly improve cardiovascular risk stratification compared to traditional methods.
• These imaging modalities offer personalized insights for lipid-lowering and antiplatelet therapy selection.
• Plaque assessment via CCTA enables monitoring of treatment efficacy and personalized anti-atherosclerotic strategies.