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Coronary Calcification: Roles in Risk Prediction and Monitoring Therapies

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Imaging Coronary Atherosclerosis

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Cardiovascular disease is the leading cause of mortality in the USA and worldwide. Traditional risk factor assessment may not fully account for the coronary risk and underestimate the prediction of risk even in patients with established risk factors for atherosclerosis. Coronary artery calcium (CAC) represents calcified atherosclerosis in the coronary arteries. It has been shown to be the strongest predictor of adverse future cardiovascular events and provides incremental information to the traditional risk factors. It has been incorporated into the ACC/AHA guidelines for risk assessment of asymptomatic intermediate risk (10–20 % 10-year risk), low to intermediate risk (6–10 % 10-year risk), and diabetic individuals. CAC can be used to reclassify individuals based on traditional risk factor assessment and provide opportunity to better strategize the therapeutic options for these subjects. Baseline CAC represents a single point in time on atherosclerosis time curve whereas progression of CAC over time presents the slope of that curve. CAC progression has also been identified as a risk for future cardiovascular events. However, the role of CAC progression as a primary end point for following up statin treatment effect may not be appropriate due to micro-calcifications caused by the statin treatments. There are certain non-statin treatments such as nifedipine, aged garlic extract, and unopposed estrogen replacement that have shown promising results in reducing the progression of CAC.

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Authors and Affiliations

  1. Department of Medicine/Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA, 90502, USA

    Irfan Zeb MD & Matthew J. Budoff MD, FACC, FAHA

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  1. Irfan Zeb MD
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  2. Matthew J. Budoff MD, FACC, FAHA
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Correspondence to Irfan Zeb MD .

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Editors and Affiliations

  1. South Australian Health and Medical Research Institute, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia, Australia

    Stephen J. Nicholls

  2. Project Development, C5Research, Cleveland, Ohio, USA

    Tim Crowe

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Zeb, I., Budoff, M.J. (2014). Coronary Calcification: Roles in Risk Prediction and Monitoring Therapies. In: Nicholls, S., Crowe, T. (eds) Imaging Coronary Atherosclerosis. Contemporary Cardiology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0572-0_11

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