eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
SCImago Journal & Country Rank
 
3/2022
vol. 18
 
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abstract:
Review paper

An update on the coronary calcium score: a review for clinicians

Monika Z. Czaja-Ziółkowska
1
,
Jarosław Wasilewski
1
,
Mariusz Gąsior
1
,
Jan Głowacki
2, 3

1.
3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
2.
Department of Radiology and Radiodiagnostics, Silesian Medical University, Zabrze, Poland
3.
Computed Tomography Laboratory, Silesian Centre for Heart Diseases, Zabrze, Poland
Adv Interv Cardiol 2022; 18, 3 (69): 201–205
Online publish date: 2022/12/23
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The clinical manifestation of coronary artery atherosclerosis is coronary artery disease (CAD) with symptoms ranging from exertional chest pain due to reduction of coronary flow reserve to acute coronary syndrome due to rupture of usually a nonobstructive plaque with abrupt coronary blood flow reduction. CAD is the leading cause of morbidity and mortality worldwide. Therefore, identifying asymptomatic people at risk of CAD is pivotal to guide decision-making for primary prevention. Coronary artery calcium (CAC) is a hallmark of coronary artery atherosclerosis. It can be detected using cardiac computed tomography and quantified by the Agatston method. CAC examination is a cheap, fast and low radiation dose test, without injecting a contrast agent. It provides prognostic information over other traditional cardiovascular risk markers and established scoring systems, especially for low-risk subgroups such as women and younger adults, and indicates the appropriate moment to implement primary prevention, including acetylsalicylic acid and statins. In this review, we discuss the methods of CAC evaluation, the meaning of a zero CAC score (CACS), its conversion to CACS > 0 and the impact of this fact on cardiovascular risk, the effect of statins and proprotein convertase subtilisin/kexin type 9 inhibitor on CAC progression, interpretation of CACS results, and CACS prognostic value in both asymptomatic and symptomatic patients.
keywords:

computed tomography, coronary artery calcium, coronary artery disease

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