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Review
. 2017 May-Jun;50(3):182-189.
doi: 10.1590/0100-3984.2015.0235.

Coronary artery calcium score: current status

Priscilla Ornellas Neves  1 , Joalbo Andrade  2 , Henry Monção  1
Affiliations
Review

Coronary artery calcium score: current status

Priscilla Ornellas Neves et al. Radiol Bras. 2017 May-Jun.

Abstract
in English, Portuguese

The coronary artery calcium score plays an Important role In cardiovascular risk stratification, showing a significant association with the medium- or long-term occurrence of major cardiovascular events. Here, we discuss the following: protocols for the acquisition and quantification of the coronary artery calcium score by multidetector computed tomography; the role of the coronary artery calcium score in coronary risk stratification and its comparison with other clinical scores; its indications, interpretation, and prognosis in asymptomatic patients; and its use in patients who are symptomatic or have diabetes.

O escore de cálcio coronariano tem papel relevante na estratificação de risco cardiovascular, apresentando significativa associação com a ocorrência de eventos cardiovasculares maiores no acompanhamento de médio e longo prazo. São discutidos: os protocolos de aquisição e quantificação por meio da tomografia computadorizada multidetectores; seu papel na estratificação de risco coronariano e relação com os demais escores clínicos; suas indicações, interpretação e prognóstico em pacientes assintomáticos; sua utilização em pacientes sintomáticos e em diabéticos.

Keywords: Calcinosis/diagnosis; Cardiomyopathies/diagnosis; Cardiovascular diseases/epidemiology; Coronary artery disease/epidemiology; Tomography, X-ray computed.

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Figures

Figure 1
Figure 1
Tool for calculating the CAC score in percentiles, according to the distribution by age, gender, and ethnicity, as per the MESA.
Figure 2
Figure 2
CAC score in a 51-year-old White female. A: Calcified plaque in the anterior descending artery. CAC score = 36 (Agatston method), consistent with discrete coronary calcification, indicating low cardiovascular risk. B: However, if the CAC score adjusted for age, gender, and ethnicity is used, according to the MESA, the score should be considered as being accentuated, indicating marked cardiovascular risk, because it is above the 90th percentile for this group.
Figure 3
Figure 3
CAC score in a 65-year-old white male. A: Calcified plaques in the anterior descending artery, in addition to others (not shown) in the other coronary arteries. CAC score = 285 (Agatston method), consistent with moderate coronary calcification, indicating moderate cardiovascular risk. B: However, if the CAC score adjusted for age, gender, and ethnicity is used, according to the MESA, the calcium score should be considered discrete, indicating a low cardiovascular risk because it is below the 75th percentile for this group. C: If this same CAC score (Agatston 285) had been found in a woman of the same age and ethnicity, her adjusted score would be considered pronounced, indicating marked cardiovascular risk (above the 90th percentile).
See this image and copyright information in PMC

References

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