Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?

Michael J. Blaha; Martin Bødtker Mortensen; Sina Kianoush; Rajesh Tota-Maharaj; Miguel Cainzos-Achirica

doi:10.1016/j.jcmg.2017.05.007

Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?

Michael J. Blaha, Martin Bødtker Mortensen, Sina Kianoush, Rajesh Tota-Maharaj, Miguel Cainzos-Achirica

Academic Institute

Research output: Contribution to journal › Review article › peer-review

264 Scopus citations

Abstract

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).

Original language	English (US)
Pages (from-to)	923-937
Number of pages	15
Journal	JACC: Cardiovascular Imaging
Volume	10
Issue number	8
DOIs	https://doi.org/10.1016/j.jcmg.2017.05.007
State	Published - Aug 2017

Keywords

cardiac CT
cardiovascular disease
coronary artery calcium
prediction
risk
score

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.jcmg.2017.05.007

Cite this

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title = "Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?",

abstract = "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).",

keywords = "cardiac CT, cardiovascular disease, coronary artery calcium, prediction, risk, score",

author = "Blaha, \{Michael J.\} and Mortensen, \{Martin B{\o}dtker\} and Sina Kianoush and Rajesh Tota-Maharaj and Miguel Cainzos-Achirica",

note = "Publisher Copyright: {\textcopyright} 2017 American College of Cardiology Foundation",

year = "2017",

month = aug,

doi = "10.1016/j.jcmg.2017.05.007",

language = "English (US)",

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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

PY - 2017/8

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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).

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).

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KW - cardiovascular disease

KW - coronary artery calcium

KW - prediction

KW - risk

KW - score

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Coronary Artery Calcium Scoring: Is It Time for a Change in Methodology?

Abstract

Keywords

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