TY - JOUR
T1 - Coronary artery calcium progression
T2 - An important clinical measurement?
AU - McEvoy, John W.
AU - Blaha, Michael J.
AU - DeFilippis, Andrew P.
AU - Budoff, Matthew J.
AU - Nasir, Khurram
AU - Blumenthal, Roger S.
AU - Jones, Steven R.
N1 - Funding Information:
Dr. DeFilippis is supported by a National Research Service Award (NRSA) Training Grant ( T32-HL-07227 ). Dr. Budoff is on the Speakers' Bureau of GE. Dr. Jones has received research grant support from Atherotech and served as a consultant to Abbott Pharmaceuticals. All other authors have reported that they have no relationships to disclose.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2010/11/9
Y1 - 2010/11/9
N2 - Baseline coronary artery calcification (CAC) accurately identifies coronary atherosclerosis and might improve prediction of future cardiac events. Serial assessment of CAC scores has been proposed for monitoring atherosclerosis progression and for assessing the effectiveness of medical therapies aimed at reducing cardiac risk. However, whether knowledge of progression of CAC scores over time further improves risk prediction is unclear. Several trials relating medical therapies to CAC progression have been performed without any formal guidelines on the definition of CAC progression and how it is best quantified. We conducted a comprehensive review of published reports on CAC progression. Increased CAC progression is associated with many known cardiac risk factors. We found that CAC progression correlates with worsening atherosclerosis and may facilitate prediction of future cardiac events. These findings support the notion that slowing CAC progression with therapeutic interventions might provide prognostic benefit. However, despite promising early data, such interventions (most notably with statin therapy) have not been shown to slow the progression of CAC in any randomized controlled trial to date, outside of post hoc subgroup analyses. Thus, routine quantification of CAC progression cannot currently be recommended in clinical practice. First, standards of how CAC progression should be defined and assessed need to be developed. In addition, there remains a need for further studies analyzing the effect of other cardiac therapies on CAC progression and cardiac outcomes.
AB - Baseline coronary artery calcification (CAC) accurately identifies coronary atherosclerosis and might improve prediction of future cardiac events. Serial assessment of CAC scores has been proposed for monitoring atherosclerosis progression and for assessing the effectiveness of medical therapies aimed at reducing cardiac risk. However, whether knowledge of progression of CAC scores over time further improves risk prediction is unclear. Several trials relating medical therapies to CAC progression have been performed without any formal guidelines on the definition of CAC progression and how it is best quantified. We conducted a comprehensive review of published reports on CAC progression. Increased CAC progression is associated with many known cardiac risk factors. We found that CAC progression correlates with worsening atherosclerosis and may facilitate prediction of future cardiac events. These findings support the notion that slowing CAC progression with therapeutic interventions might provide prognostic benefit. However, despite promising early data, such interventions (most notably with statin therapy) have not been shown to slow the progression of CAC in any randomized controlled trial to date, outside of post hoc subgroup analyses. Thus, routine quantification of CAC progression cannot currently be recommended in clinical practice. First, standards of how CAC progression should be defined and assessed need to be developed. In addition, there remains a need for further studies analyzing the effect of other cardiac therapies on CAC progression and cardiac outcomes.
KW - Atherosclerosis
KW - Cardiac CT
KW - Coronary artery calcium
KW - Progression
KW - Review
UR - http://www.scopus.com/inward/record.url?scp=78751691043&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78751691043&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2010.06.038
DO - 10.1016/j.jacc.2010.06.038
M3 - Review article
C2 - 21050970
AN - SCOPUS:78751691043
VL - 56
SP - 1613
EP - 1622
JO - Journal of the American College of Cardiology.
JF - Journal of the American College of Cardiology.
SN - 0735-1097
IS - 20
ER -