TY - JOUR
T1 - The evolving role of coronary artery calcium in preventive cardiology 30 years after the Agatston score
AU - Kapoor, Karan
AU - Cainzos-Achirica, Miguel
AU - Nasir, Khurram
PY - 2020/9/1
Y1 - 2020/9/1
N2 - PURPOSE OF REVIEW: On the brink of the 30th anniversary of the Agatston score we summarize the epidemiological data that shaped the recommendations relevant to coronary artery calcium (CAC) included in the 2018/2019 US and European guidelines for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). We also discuss the implications of novel CAC research conducted in asymptomatic populations within the past 2 years. RECENT FINDINGS: Based on a wealth of observational evidence, CAC has emerged as a mainstay in personalized risk assessment and is now endorsed as a class IIa tool in both US and European guidelines. In the past 2 years, data supporting the prognostic power of CAC has kept mounting, with longer term follow-up data now available. CAC has been evaluated in a variety of patient populations including individuals with severe hypercholesterolemia, diabetes mellitus and younger adults with family history of ASCVD, in all of whom it may be able to inform a more personalized management. Novel CAC scoring approaches are also discussed. SUMMARY: Despite a strong endorsement in recent guidelines, active research in the last 2 years has provided further insights on the potential utility of CAC in informing a more individualized preventive management in broader populations.
AB - PURPOSE OF REVIEW: On the brink of the 30th anniversary of the Agatston score we summarize the epidemiological data that shaped the recommendations relevant to coronary artery calcium (CAC) included in the 2018/2019 US and European guidelines for the primary prevention of atherosclerotic cardiovascular disease (ASCVD). We also discuss the implications of novel CAC research conducted in asymptomatic populations within the past 2 years. RECENT FINDINGS: Based on a wealth of observational evidence, CAC has emerged as a mainstay in personalized risk assessment and is now endorsed as a class IIa tool in both US and European guidelines. In the past 2 years, data supporting the prognostic power of CAC has kept mounting, with longer term follow-up data now available. CAC has been evaluated in a variety of patient populations including individuals with severe hypercholesterolemia, diabetes mellitus and younger adults with family history of ASCVD, in all of whom it may be able to inform a more personalized management. Novel CAC scoring approaches are also discussed. SUMMARY: Despite a strong endorsement in recent guidelines, active research in the last 2 years has provided further insights on the potential utility of CAC in informing a more individualized preventive management in broader populations.
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U2 - 10.1097/HCO.0000000000000771
DO - 10.1097/HCO.0000000000000771
M3 - Article
C2 - 32649358
AN - SCOPUS:85089300609
VL - 35
SP - 500
EP - 507
JO - Current Opinion in Cardiology
JF - Current Opinion in Cardiology
SN - 0268-4705
IS - 5
ER -