Coronary Artery Calcium Scoring: a Valuable Aid in Shared Decision Making Among Non-traditional Risk Markers

Purpose of the Review

The purpose of this study was to evaluate the utility of coronary artery calcium (CAC) scoring and compare it with other non-traditional cardiovascular risk markers for improvement in cardiovascular risk assessment.

Recent Findings

CAC scoring refines risk assessment among asymptomatic patients eligible for primary prevention across the spectrum of cardiovascular risk. Its use has been well-validated in several multi-ethnic population-based cohorts. With the recent ACC/AHA cholesterol treatment guidelines expanding the eligibility for statin therapy for primary prevention, the absence of CAC can be a powerful tool for identifying those at lower risk of future cardiovascular events. CAC is superior to other non-traditional risk markers recognized by the current risk assessment guidelines for re-classifying patients to appropriate risk categories and improving discrimination of risk beyond traditional risk factors.

Summary

CAC scoring is a reliable decision-making tool for improving cardiovascular risk assessment and performs better than other non-traditional risk markers, particularly when used to identify those at lower risk (i.e., CAC = 0).