Back to Browse Journals » Vascular Health and Risk Management » Volume 4 » Issue 2

Expert review on coronary calcium

Authors Matthew J Budoff, Khawar M Gul

Published Date May 2008 Volume 2008:4(2) Pages 315—324

DOI http://dx.doi.org/10.2147/VHRM.S1160

Published 5 May 2008

Matthew J Budoff, Khawar M Gul

Division of Cardiology, Saint John’s Cardiovascular Research Center, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, California, USA

Abstract: While there is no doubt that high risk patients (those with >20% ten year risk of future cardiovascular event) need more aggressive preventive therapy, a majority of cardiovascular events occur in individuals at intermediate risk (10%–20% ten year risk). Accurate risk assessment may be helpful in decreasing cardiovascular events through more appropriate targeting of preventive measures. It has been suggested that traditional risk assessment may be refined with the selective use of coronary artery calcium (CAC) or other methods of subclinical atherosclerosis measurement. Coronary calcification is a marker of atherosclerosis that can be quantified with the use of cardiac CT and it is proportional to the extent and severity of atherosclerotic disease. The published studies demonstrate a high sensitivity of CAC for the presence of coronary artery disease but a lower specificity for obstructive CAD depending on the magnitude of the CAC. Several large clinical trials found clear, incremental predictive value of CAC over the Framingham risk score when used in asymptomatic patients. Based on multiple observational studies, patients with increased plaque burdens (increased CAC) are approximately ten times more likely to suffer a cardiac event over the next 3–5 years. Coronary calcium scores have outperformed conventional risk factors, highly sensitive C-reactive protein (CRP) and carotid intima media thickness (IMT) as a predictor of cardiovascular events. The relevant prognostic information obtained may be useful to initiate or intensify appropriate treatment strategies to slow the progression of atherosclerotic vascular disease. Current data suggests intermediate risk patients may benefit most from further risk stratification with cardiac CT, as CAC testing is effective at identifying increased risk and in motivating effective behavioral changes. This article reviews information pertaining to the clinical use of CAC for assessing coronary atherosclerosis as a useful predictor of coronary artery disease (CAD) in certain population of patients.

Keywords: computed tomography, electron beam, prognosis, review, coronary artery calcification, calcium score, atherosclerosis, multi-detector computed tomography

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Other article by this author:

Mild and moderate pre-dialysis chronic kidney disease is associated with increased coronary artery calcium

Roy SK, Cespedes A, Li D, Choi TY, Budoff MJ

Vascular Health and Risk Management 2011, 7:719-724

Published Date: 2 December 2011

Readers of this article also read:

Postoperative subconjunctival bevacizumab injection as an adjunct to 5-fluorouracil in the management of scarring after trabeculectomy

Freiberg FJ, Matlach J, Grehn F, Karl S, Klink T

Clinical Ophthalmology 2013, 7:1211-1217

Published Date: 20 June 2013

Reversal of multidrug resistance by cisplatin-loaded magnetic Fe3O4 nanoparticles in A549/DDP lung cancer cells in vitro and in vivo

Li K, Chen B, Xu L, Feng J, Xia G, Cheng J, Wang J, Gao F, Wang X

International Journal of Nanomedicine 2013, 8:1867-1877

Published Date: 9 May 2013

Large bilateral foveal cysts in the inner retina of a patient treated with tamoxifen, diagnosed with Fourier-domain optical coherence tomography

Georgalas I, Paraskevopoulos T, Papaconstantinou D, Brouzas D, Koutsandrea C

Clinical Ophthalmology 2013, 7:707-709

Published Date: 10 April 2013

Development of a novel niosomal system for oral delivery of Ginkgo biloba extract

Jin Y, Wen JY, Garg S, Liu D, Zhou YL, Teng LR, Zhang WY

International Journal of Nanomedicine 2013, 8:421-430

Published Date: 24 January 2013

Comparison of different intraocular pressure measurement techniques in normal eyes, post surface and post lamellar refractive surgery

Shousha SM, Abo Steit MA, Hosny MH, Ewais WA, Shalaby AM

Clinical Ophthalmology 2013, 7:71-79

Published Date: 8 January 2013

Subtle cytotoxicity and genotoxicity differences in superparamagnetic iron oxide nanoparticles coated with various functional groups

Hong SC, Lee JH, Lee J, Kim HY, Park JY, Cho J, Lee J, Han DW

International Journal of Nanomedicine 2011, 6:3219-3231

Published Date: 7 December 2011

Influence of cataract surgery and blood pressure changes caused by sodium restriction on retinal vascular diameter

Takatoshi Tano, Yoshimune Hiratsuka, Koichi Ono, et al

Clinical Ophthalmology 2010, 4:1299-1309

Published Date: 15 November 2010

Manidipine–delapril combination in the management of hypertension

Manuel Luque Otero

Vascular Health and Risk Management 2007, 3:255-263

Published Date: 15 August 2007