Addressing Knowledge Gaps in the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: a Review of Recent Coronary Artery Calcium Literature.

摘要: Coronary artery calcium (CAC) has been proposed as an integrator of information from traditionally measured, non-traditionally and unmeasured risk factors for coronary atherosclerosis. The 2013 American College Cardiology/American Heart Association Guideline on the Assessment Cardiovascular Risk identified several knowledge gaps regarding CAC, including radiation risks, cost-effectiveness, improving discrimination reclassification estimated over Pooled Cohort Equations in ACC/AHA Atherosclerotic Disease Estimator. In this review, we focus recent CAC literature addressing these gaps. We further highlight potential to enrich future randomized controlled trials. use allows personalization cardiovascular despite presence or absence traditional across many demographics. Avenues reduce exposure associated with scanning include increasing interval between scans those scores zero estimating non-cardiac gated CT scans. While limited studies have suggested cost-effectiveness cardiac assessment incorporation screening algorithms, demonstrated ability identify non-traditional that may be used expand other high-risk populations. Literature past 2 years supports a strong marker personalize assessment. multiple avenues are available analyses encouraging, necessary clarify patient selection given interplay imaging modalities algorithms.