TY - JOUR
T1 - Coronary Artery Calcium
T2 - Recommendations for Risk Assessment in Cardiovascular Prevention Guidelines
AU - Al Rifai, Mahmoud
AU - Cainzos-Achirica, Miguel
AU - Kianoush, Sina
AU - Mirbolouk, Mohammadhassan
AU - Peng, Alison
AU - Comin-Colet, Josep
AU - Blaha, Michael J.
N1 - Funding Information:
1Department of Internal Medicine, The University of Kansas School of Medicine, Wichita, KS, USA *,2Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Blalock 524D1, 600 N Wolfe St, Baltimore, MD, 21287, USA Email: [email protected] 3Department of Cardiology, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain 4Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain 5RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain 6Department of Internal Medicine, Yale New Haven Medical Center Waterbury Program, Waterbury, CT, USA 7Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain 8Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
Funding Information:
Mahmoud Al Rifai, Miguel Cainzos-Achirica, Sina Kianoush, Mohammadhassan Mirbolouk, Alison Peng, and Josep Comin-Colet each declare no potential conflicts of interest. Michael J. Blaha reports grants from NIH, FDA, Aetna Foundation, and Amgen Foundation and honoraria from Amgen, Sanofi, Regeneron, Medimmune, Novartis, Alcea, and Novo Nordisk.
Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Purpose of review: In this review, we evaluate the coronary artery calcium (CAC) score as a biomarker for advanced atherosclerotic cardiovascular disease (ASCVD) risk assessment. Recent findings: We summarize the evidence from multiple epidemiological studies, which show a clear advantage of CAC compared to traditional and non-traditional cardiovascular risk factors. We then compare the recommendations included in the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and in the 2017 Society of Cardiovascular Computed Tomography (SCCT) guidelines for the use of CAC in ASCVD risk assessment, and examine the recent 2018 US Preventive Services Task Force (USPSTF) document. Finally, based on the currently available evidence, we provide constructive input for the upcoming ACC/AHA guidelines, regarding the population in whom CAC is most likely to be informative, the level of evidence that we believe should be assigned to CAC as an advanced ASCVD risk assessment tool, and the special populations in whom CAC might be beneficial for further risk assessment. Summary: We support a pragmatic approach that combines the pooled cohort equations (PCE) for initial ASCVD risk stratification, followed by CAC for refining ASCVD risk assessment among a broad range of intermediate risk patients and other special groups.
AB - Purpose of review: In this review, we evaluate the coronary artery calcium (CAC) score as a biomarker for advanced atherosclerotic cardiovascular disease (ASCVD) risk assessment. Recent findings: We summarize the evidence from multiple epidemiological studies, which show a clear advantage of CAC compared to traditional and non-traditional cardiovascular risk factors. We then compare the recommendations included in the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and in the 2017 Society of Cardiovascular Computed Tomography (SCCT) guidelines for the use of CAC in ASCVD risk assessment, and examine the recent 2018 US Preventive Services Task Force (USPSTF) document. Finally, based on the currently available evidence, we provide constructive input for the upcoming ACC/AHA guidelines, regarding the population in whom CAC is most likely to be informative, the level of evidence that we believe should be assigned to CAC as an advanced ASCVD risk assessment tool, and the special populations in whom CAC might be beneficial for further risk assessment. Summary: We support a pragmatic approach that combines the pooled cohort equations (PCE) for initial ASCVD risk stratification, followed by CAC for refining ASCVD risk assessment among a broad range of intermediate risk patients and other special groups.
KW - Atherosclerotic cardiovascular disease
KW - Coronary artery calcium
KW - Prevention
KW - Risk assessment
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=85054142404&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054142404&partnerID=8YFLogxK
U2 - 10.1007/s11936-018-0685-0
DO - 10.1007/s11936-018-0685-0
M3 - Review article
AN - SCOPUS:85054142404
SN - 1092-8464
VL - 20
JO - Current Treatment Options in Cardiovascular Medicine
JF - Current Treatment Options in Cardiovascular Medicine
IS - 11
M1 - 89
ER -