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
N1 - Funding Information:
K.N. is supported by Jerold B. Katz Academy of Translational Research. K.K. and M.C-A. have no financial support to disclose.
Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2020/9
Y1 - 2020/9
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.
KW - Cardiovascular disease
KW - Coronary artery calcium
KW - Prevention
KW - Risk
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U2 - 10.1097/HCO.0000000000000771
DO - 10.1097/HCO.0000000000000771
M3 - Review 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 -