Measurement and Application of Incidentally Detected Coronary Calcium: JACC Review Topic of the Week

Shyon Parsa; Adam Saleh; Viraj Raygor; Natalie Hoeting; Anjali Rao; Ann Marie Navar; Anand Rohatgi; Fernando Kay; Suhny Abbara; Amit Khera; Parag H Joshi

doi:10.1016/j.jacc.2024.01.039

Measurement and Application of Incidentally Detected Coronary Calcium: JACC Review Topic of the Week

J Am Coll Cardiol. 2024 Apr 23;83(16):1557-1567. doi: 10.1016/j.jacc.2024.01.039.

Authors

Shyon Parsa¹, Adam Saleh², Viraj Raygor³, Natalie Hoeting⁴, Anjali Rao⁴, Ann Marie Navar⁴, Anand Rohatgi⁴, Fernando Kay⁵, Suhny Abbara⁵, Amit Khera⁴, Parag H Joshi⁶

Affiliations

¹ Department of Internal Medicine, Division of Cardiology, the UT Southwestern Medical Center, Dallas, Texas, USA; Department of Internal Medicine, Stanford University Hospital, Stanford, California, USA.
² Texas A&M University, Engineering Medicine, Houston, Texas, USA.
³ Sutter Health, Cardiovascular Health, Palo Alto, California, USA.
⁴ Department of Internal Medicine, Division of Cardiology, the UT Southwestern Medical Center, Dallas, Texas, USA.
⁵ Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, Dallas, Texas, USA.
⁶ Department of Internal Medicine, Division of Cardiology, the UT Southwestern Medical Center, Dallas, Texas, USA. Electronic address: Parag.Joshi@utsouthwestern.edu.

PMID: 38631775
DOI: 10.1016/j.jacc.2024.01.039

Abstract

Coronary artery calcium (CAC) scoring is a powerful tool for atherosclerotic cardiovascular disease risk stratification. The nongated, noncontrast chest computed tomography scan (NCCT) has emerged as a source of CAC characterization with tremendous potential due to the high volume of NCCT scans. Application of incidental CAC characterization from NCCT has raised questions around score accuracy, standardization of methodology including the possibility of deep learning to automate the process, and the risk stratification potential of an NCCT-derived score. In this review, the authors aim to summarize the role of NCCT-derived CAC in preventive cardiovascular health today as well as explore future avenues for eventual clinical applicability in specific patient populations and broader health systems.

Keywords: cardiovascular imaging; coronary artery calcium; heart disease; patient-centered care pathways; personalized medicine; preventive health.

Publication types

Review

MeSH terms

Atherosclerosis*
Calcium
Coronary Angiography
Coronary Artery Disease*
Coronary Vessels
Heart
Humans
Risk Factors
Tomography, X-Ray Computed / methods
Vascular Calcification*

Substances

Calcium