TY - JOUR
T1 - Coronary Artery Calcium Scoring
T2 - Is It Time for a Change in Methodology?
AU - Blaha, Michael J.
AU - Mortensen, Martin Bødtker
AU - Kianoush, Sina
AU - Tota-Maharaj, Rajesh
AU - Cainzos-Achirica, Miguel
N1 - Publisher Copyright:
© 2017 American College of Cardiology Foundation
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/8
Y1 - 2017/8
N2 - Quantification of coronary artery calcium (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk. Formal CAC scoring was introduced in 1990, with early scoring algorithms notable for their simplicity and elegance. Yet, with little evidence available on how to best build a score, and without a conceptual model guiding score development, these scores were, to a large degree, arbitrary. In this review, we describe the traditional approaches for clinical CAC scoring, noting their strengths, weaknesses, and limitations. We then discuss a conceptual model for developing an improved CAC score, reviewing the evidence supporting approaches most likely to lead to meaningful score improvement (for example, accounting for CAC density and regional distribution). After discussing the potential implementation of an improved score in clinical practice, we follow with a discussion of the future of CAC scoring, asking the central question: do we really need a new CAC score?
AB - Quantification of coronary artery calcium (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk. Formal CAC scoring was introduced in 1990, with early scoring algorithms notable for their simplicity and elegance. Yet, with little evidence available on how to best build a score, and without a conceptual model guiding score development, these scores were, to a large degree, arbitrary. In this review, we describe the traditional approaches for clinical CAC scoring, noting their strengths, weaknesses, and limitations. We then discuss a conceptual model for developing an improved CAC score, reviewing the evidence supporting approaches most likely to lead to meaningful score improvement (for example, accounting for CAC density and regional distribution). After discussing the potential implementation of an improved score in clinical practice, we follow with a discussion of the future of CAC scoring, asking the central question: do we really need a new CAC score?
KW - cardiac CT
KW - cardiovascular disease
KW - coronary artery calcium
KW - prediction
KW - risk
KW - score
UR - http://www.scopus.com/inward/record.url?scp=85026859106&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026859106&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2017.05.007
DO - 10.1016/j.jcmg.2017.05.007
M3 - Review article
C2 - 28797416
AN - SCOPUS:85026859106
VL - 10
SP - 923
EP - 937
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
SN - 1936-878X
IS - 8
ER -