TY - JOUR
T1 - The implication of coronary artery calcium testing for cardiovascular disease prevention and diabetes
AU - Blankstein, Ron
AU - Gupta, Ankur
AU - Rana, Jamal S.
AU - Nasir, Khurram
N1 - Publisher Copyright:
© 2017 Korean Endocrine Society.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Over the last two decades coronary artery calcium (CAC) scanning has emerged as a quick, safe, and inexpensive method to detect the presence of coronary atherosclerosis. Data from multiple studies has shown that compared to individuals who do not have any coronary calcifications, those with severe calcifications (i.e., CAC score > 300) have a 10-fold increase in their risk of coronary heart disease events and cardiovascular disease. Conversely, those that have a CAC of 0 have a very low event rate (~0.1%/year), with data that now extends to 15 years in some studies. Thus, the most notable implication of identifying CAC in individuals who do not have known cardiovascular disease is that it allows targeting of more aggressive therapies to those who have the highest risk of having future events. Such identification of risk is especially important for individuals who are not on any therapies for coronary heart disease, or when intensification of treatment is being considered but has an uncertain role. This review will highlight some of the recent data on CAC testing, while focusing on the implications of those findings on patient management. The evolving role of CAC in patients with diabetes will also be highlighted.
AB - Over the last two decades coronary artery calcium (CAC) scanning has emerged as a quick, safe, and inexpensive method to detect the presence of coronary atherosclerosis. Data from multiple studies has shown that compared to individuals who do not have any coronary calcifications, those with severe calcifications (i.e., CAC score > 300) have a 10-fold increase in their risk of coronary heart disease events and cardiovascular disease. Conversely, those that have a CAC of 0 have a very low event rate (~0.1%/year), with data that now extends to 15 years in some studies. Thus, the most notable implication of identifying CAC in individuals who do not have known cardiovascular disease is that it allows targeting of more aggressive therapies to those who have the highest risk of having future events. Such identification of risk is especially important for individuals who are not on any therapies for coronary heart disease, or when intensification of treatment is being considered but has an uncertain role. This review will highlight some of the recent data on CAC testing, while focusing on the implications of those findings on patient management. The evolving role of CAC in patients with diabetes will also be highlighted.
KW - Atherosclerosis
KW - Coronary artery disease
KW - Diabetes
KW - Prevention and control
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U2 - 10.3803/EnM.2017.32.1.47
DO - 10.3803/EnM.2017.32.1.47
M3 - Review article
AN - SCOPUS:85015874159
SN - 2093-596X
VL - 32
SP - 47
EP - 57
JO - Endocrinology and Metabolism
JF - Endocrinology and Metabolism
IS - 1
ER -