The evolving role of coronary artery calcium in preventive cardiology 30 years after the Agatston score

Karan Kapoor, Miguel Cainzos-Achirica, Khurram Nasir

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)500-507
Number of pages8
JournalCurrent Opinion in Cardiology
Issue number5
StatePublished - Sep 2020


  • Cardiovascular disease
  • Coronary artery calcium
  • Prevention
  • Risk

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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