Coronary artery calcium scoring in cardiovascular risk assessment

Cardiovasc Ther. 2011 Dec;29(6):e43-53. doi: 10.1111/j.1755-5922.2010.00172.x. Epub 2010 Jun 14.


Identification of patients at risk of future coronary artery disease (CAD) events traditionally relies on scoring tools that take demographic and clinical characteristics into account (e.g., the Framingham risk score in the United States and the Heart Score in Europe). Although these scoring tools have been shown to have a good predictive value, they may still fail to recognize a proportion of patients with coronary atherosclerosis at risk for future CAD events. In order to improve risk stratification, direct visualization of subclinical atherosclerosis has been advocated. Electron-beam computed tomography and multislice computed tomography provide a direct estimation of coronary calcium, a marker of coronary atherosclerosis. A large amount of data is available supporting the clinical value of the noninvasive assessment of coronary artery calcium score (CACS) with these techniques and its incremental prognostic information over traditional risk stratification. Aim of this review is to provide an overview of the literature regarding the prognostic value of CACS assessment. In addition, potential other applications of CACS assessment as well as the limitations of the technique are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography / methods*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Tomography, X-Ray Computed*
  • Vascular Calcification / diagnostic imaging*
  • Vascular Calcification / epidemiology
  • Vascular Calcification / therapy