Cardiac risk stratification: Role of the coronary calcium score

Abstract

Rakesh K Sharma1, Rajiv K Sharma1, Donald J Voelker1, Vibhuti N Singh2, Deepak Pahuja3, Teresa Nash1, Hanumanth K Reddy11Medical Center of South Arkansas, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 2Bayfront Medical Center, St Petersburg, Florida; 3Saint Vincent Health Center, Erie, PA, USAAbstract: Coronary artery calcium (CAC) is an integral part of atherosclerotic coronary heart disease (CHD). CHD is the leading cause of death in industrialized nations and there is a constant effort to develop preventative strategies. The emphasis is on risk stratification and primary risk prevention in asymptomatic patients to decrease cardiovascular mortality and morbidity. The Framingham Risk Score predicts CHD events only moderately well where family history is not included as a risk factor. There has been an exploration for new tests for better risk stratification and risk factor modification. While the Framingham Risk Score, European Systematic Coronary Risk Evaluation Project, and European Prospective Cardiovascular Munster study remain excellent tools for risk factor modification, the CAC score may have additional benefit in risk assessment. There have been several studies supporting the role of CAC score for prediction of myocardial infarction and cardiovascular mortality. It has been shown to have great scope in risk stratification of asymptomatic patients in the emergency room. Additionally, it may help in assessment of progression or regression of coronary artery disease. Furthermore, the CAC score may help differentiate ischemic from nonischemic cardiomyopathy.Keywords: coronary calcium scoring, coronary artery disease, CAC, cardiomyopathy, angiography, chest pain, Framingham, risk stratification, risk factors