Coronary Artery Calcium Scoring: New Insights into Clinical Interpretation-Lessons from the CAC Consortium. [Review]

MedStar author(s):
Citation: Radiology Cardiothoracic Imaging. 2(6):e200281, 2020 Dec.PMID: 33385165Institution: MedStar Union Memorial HospitalDepartment: MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2020ISSN:
  • 2638-6135
Name of journal: Radiology. Cardiothoracic imagingAbstract: Coronary artery calcium (CAC) is a highly specific marker for coronary atherosclerosis. The CAC Consortium, a multicenter, retrospective, real-world cohort study, was established to investigate the association between CAC and long-term, cause-specific mortality. This review summarizes findings from CAC Consortium studies published between 2016 and 2020, aiming to demystify CAC as a clinical decision-guiding tool and push the limits of who might benefit from CAC in clinical practice. CAC has been shown to effectively stratify cardiovascular risk across ethnicities irrespective of age, sex, and risk factor burden. In comparison to other widely used risk scores, CAC appears to be most consistent in its ability to add to cardiovascular disease (CVD) event prediction. Beyond risk stratification, CAC has been shown to identify high-risk patient subgroups. While currently recommended only for patients at borderline or intermediate risk by the American College of Cardiology/American Heart Association (10-year atherosclerotic CVD event risk, 5% to < 20%), CAC scoring may also provide value in select young patients aged 30-49 years and in low-risk patients with a family history. While new studies emphasize that patients with a CAC greater than or equal to 1000 be considered a distinct patient group, a CAC of 0 has additionally emerged to be a reliable negative risk factor, identifying patients at low risk of both CVD and non-CVD mortality. (c) RSNA, 2020. Copyright 2020 by the Radiological Society of North America, Inc.All authors: Adelhoefer S, Blaha MJ, Dzaye O, Obisesan OH, Osei AD, Uddin SMIFiscal year: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-02-17
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Journal Article MedStar Authors Catalog Article 33385165 Available 33385165

Coronary artery calcium (CAC) is a highly specific marker for coronary atherosclerosis. The CAC Consortium, a multicenter, retrospective, real-world cohort study, was established to investigate the association between CAC and long-term, cause-specific mortality. This review summarizes findings from CAC Consortium studies published between 2016 and 2020, aiming to demystify CAC as a clinical decision-guiding tool and push the limits of who might benefit from CAC in clinical practice. CAC has been shown to effectively stratify cardiovascular risk across ethnicities irrespective of age, sex, and risk factor burden. In comparison to other widely used risk scores, CAC appears to be most consistent in its ability to add to cardiovascular disease (CVD) event prediction. Beyond risk stratification, CAC has been shown to identify high-risk patient subgroups. While currently recommended only for patients at borderline or intermediate risk by the American College of Cardiology/American Heart Association (10-year atherosclerotic CVD event risk, 5% to < 20%), CAC scoring may also provide value in select young patients aged 30-49 years and in low-risk patients with a family history. While new studies emphasize that patients with a CAC greater than or equal to 1000 be considered a distinct patient group, a CAC of 0 has additionally emerged to be a reliable negative risk factor, identifying patients at low risk of both CVD and non-CVD mortality. (c) RSNA, 2020. Copyright 2020 by the Radiological Society of North America, Inc.

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