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Beyond the Heart: The Predictive Role of Coronary Artery Calcium Scoring in Non-Cardiovascular Disease Risk
Viviana Cortiana1,2, Hetvee Vaghela1,3, Rahul Bakhle1,4
1PearResearch, Dehradun 248001, India.
Insights
Coronary artery calcium scoring (CACS) predicts risks beyond heart disease, including various non-cardiovascular conditions and mortality. This non-invasive tool shows potential for early diagnosis and prognosis across multiple diseases.
Area of Science:
- Cardiology
- Preventive Medicine
- Radiology
Background:
- Coronary artery calcium scoring (CACS) is a non-invasive method assessing coronary atherosclerosis.
- CACS is established for cardiovascular (CV) risk assessment in asymptomatic individuals.
- Emerging evidence links higher CACS to non-CV diseases and all-cause mortality.
Purpose of the Study:
- To review evidence on CACS for non-cardiovascular disease (non-CV) risk assessment.
- To highlight the potential of CACS in early diagnosis and prognosis of non-CV conditions.
- To explore the role of CACS in predicting CV complications secondary to non-CV diseases.
Main Methods:
- Systematic review of existing literature.
- Consolidation of evidence linking CACS to various non-CV diseases.
- Analysis of associations between CACS and disease outcomes.
Main Results:
- A strong association was found between CACS and numerous non-CV diseases.
- Included conditions: COPD, pulmonary embolism, pneumonia, diabetes, CKD, osteoporosis, MASLD, nephrolithiasis, stroke, dementia, malignancies, and autoimmune diseases.
- CACS may predict secondary CV risks associated with these non-CV conditions.
Conclusions:
- CACS demonstrates significant potential beyond traditional CV risk assessment.
- Further research, including prospective and intervention trials, is needed.
- Establishing CACS cutoff values and exploring preventative applications will aid clinical integration.
Abstract:
Coronary artery calcium scoring (CACS), a non-invasive measure of coronary atherosclerosis, has significantly enhanced cardiovascular (CV) risk assessment and stratification in asymptomatic individuals. More recently, a higher score for CAC has been associated with an increased risk of non-CV diseases and all-cause mortality. This review consolidated evidence supporting the role of CAC in assessing non-CV diseases, emphasizing its potential in early diagnosis and prognosis. We observed a strong association between CACS and non-CV diseases, viz., chronic obstructive pulmonary disease, pulmonary embolism, pneumonia, diabetes, chronic kidney disease, osteoporosis, metabolic dysfunction-associated steatotic liver disease, nephrolithiasis, stroke, dementia, malignancies, and several autoimmune diseases. Also, CAC may aid in evaluating the risk of CV conditions developing secondary to the non-CV diseases mentioned earlier. Further evidence from prospective studies, intervention trials, and population-based behavioral studies is needed to establish CAC cutoff values and explore preventative care applications, facilitating their broader integration into healthcare practices.
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