Prognostic Value of Coronary Artery Calcium

As the leading cause of death in the world, cardiovascular disease remains the most challenging era in the academic research. Early diagnosis of cardiovascular disease could help clinicians to utilize suitable preventive therapies and reduce mortality, morbidity and medical costs related to cardiovascular events. Preventive cardiology has focused on stablishing methods to identify high risk individuals for cardiac disease events. In the past thirty years, coronary artery calcium (CAC) has been studied and validated as a robust reliable indicator of subclinical atherosclerosis. Development of cardiac computed tomography (CT) made quantification of CAC score faster and more available to use. Given the Non-invasive nature of CAC scoring, investigators evaluated the CAC score in long-term population-based cohort studies. Numerous studies demonstrated that CAC score, more than other factors, correlates with likelihood of future cardiac events in the symptomatic and asymptomatic individuals. The higher CAC score predicts the higher probability of cardiovascular events in the future. One the other hand, CAC score of zero is associated with lower chance of cardiac events. Although the CAC score is a reliable predictive factor for cardiovascular events, considering all of the patient’s risk factors including traditional risk factors is suggested. This chapter discusses the history of coronary artery calcium, its predictive and prognostic value for future cardiovascular events, cost-effectiveness of CAC scoring and implication of CAC score of zero as negative risk factor for the cardiovascular event.