Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations

Cardiovascular disease remains the leading cause of mortality in the US and worldwide, and no widespread screening for this number one killer has been implemented. Traditional risk factor assessment does not fully account for the coronary risk and underestimates the prediction of risk even in patien...

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Main Author: Matthew J. Budoff
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Scientifica
Online Access:http://dx.doi.org/10.6064/2012/812046
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author Matthew J. Budoff
author_facet Matthew J. Budoff
author_sort Matthew J. Budoff
collection DOAJ
description Cardiovascular disease remains the leading cause of mortality in the US and worldwide, and no widespread screening for this number one killer has been implemented. Traditional risk factor assessment does not fully account for the coronary risk and underestimates 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. CAC consistently outperforms traditional risk factors, including models such as Framingham risk to predict future CV events. It has been incorporated into both the European and American guidelines for risk assessment. CAC is the most robust test today to reclassify individuals based on traditional risk factor assessment and provides the opportunity to better strategize the treatments for these subjects (converting patients from intermediate to high or low risk). CAC progression has also been identified as a risk for future cardiovascular events, with markedly increased events occurring in those patients exhibiting increases in calcifications over time. The exact intervals for rescanning is still being evaluated.
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spelling doaj-art-0b5525c2dfcd4d36a04daa08e4b593532025-02-03T05:48:18ZengWileyScientifica2090-908X2012-01-01201210.6064/2012/812046812046Screening for Ischemic Heart Disease with Cardiac CT: Current RecommendationsMatthew J. Budoff0Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA 90502, USACardiovascular disease remains the leading cause of mortality in the US and worldwide, and no widespread screening for this number one killer has been implemented. Traditional risk factor assessment does not fully account for the coronary risk and underestimates 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. CAC consistently outperforms traditional risk factors, including models such as Framingham risk to predict future CV events. It has been incorporated into both the European and American guidelines for risk assessment. CAC is the most robust test today to reclassify individuals based on traditional risk factor assessment and provides the opportunity to better strategize the treatments for these subjects (converting patients from intermediate to high or low risk). CAC progression has also been identified as a risk for future cardiovascular events, with markedly increased events occurring in those patients exhibiting increases in calcifications over time. The exact intervals for rescanning is still being evaluated.http://dx.doi.org/10.6064/2012/812046
spellingShingle Matthew J. Budoff
Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations
Scientifica
title Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations
title_full Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations
title_fullStr Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations
title_full_unstemmed Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations
title_short Screening for Ischemic Heart Disease with Cardiac CT: Current Recommendations
title_sort screening for ischemic heart disease with cardiac ct current recommendations
url http://dx.doi.org/10.6064/2012/812046
work_keys_str_mv AT matthewjbudoff screeningforischemicheartdiseasewithcardiacctcurrentrecommendations