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01.11.2018 | Imaging (Q Truong, Section Editor) | Ausgabe 11/2018

Current Treatment Options in Cardiovascular Medicine 11/2018

Coronary Artery Calcium: Recommendations for Risk Assessment in Cardiovascular Prevention Guidelines

Current Treatment Options in Cardiovascular Medicine > Ausgabe 11/2018
MD MPH Mahmoud Al Rifai, MD MPH Miguel Cainzos-Achirica, MD MPH Sina Kianoush, MD Mohammadhassan Mirbolouk, BS Allison Peng, MD PhD Josep Comin-Colet, MD MPH Michael J. Blaha
Wichtige Hinweise
The original version of this article was revised: In the recently published review Coronary Artery Calcium: Recommendation for Risk Assessment in Cardiovascular Prevention Guidelines,” the following author name was inadvertently misspelled as Alison Peng.
This article is part of the Topical Collection on Imaging
A correction to this article is available online at https://​doi.​org/​10.​1007/​s11936-018-0701-4.


Purpose of review

In this review, we evaluate the coronary artery calcium (CAC) score as a biomarker for advanced atherosclerotic cardiovascular disease (ASCVD) risk assessment.

Recent findings

We summarize the evidence from multiple epidemiological studies, which show a clear advantage of CAC compared to traditional and non-traditional cardiovascular risk factors. We then compare the recommendations included in the 2013 American College of Cardiology/American Heart Association (ACC/AHA) and in the 2017 Society of Cardiovascular Computed Tomography (SCCT) guidelines for the use of CAC in ASCVD risk assessment, and examine the recent 2018 US Preventive Services Task Force (USPSTF) document. Finally, based on the currently available evidence, we provide constructive input for the upcoming ACC/AHA guidelines, regarding the population in whom CAC is most likely to be informative, the level of evidence that we believe should be assigned to CAC as an advanced ASCVD risk assessment tool, and the special populations in whom CAC might be beneficial for further risk assessment.


We support a pragmatic approach that combines the pooled cohort equations (PCE) for initial ASCVD risk stratification, followed by CAC for refining ASCVD risk assessment among a broad range of intermediate risk patients and other special groups.

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