Assessment of cardiovascular calcium: Interpretation, prognostic value, and relationship to lipids and other cardiovascular risk factors

Abstract

Coronary artery calcium scanning has proven to be the most powerful predictor of cardiac risk in the primary prevention population, far exceeding conventional risk factors in prognostic value. It has also proven superior to all markers of inflammation, ankle brachial index, carotid intima-media thickness and flow mediated vasodilation. Its most accepted application is in the intermediate risk cohort, with an outcome based net reclassification index of the Framingham Risk Score exceeding 50 %. Application to young patients with a family history of premature coronary disease and to all diabetics older than 40 years of age is also appropriate.