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Coronary Artery Calcium Scoring

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Blaha, Michael J., Mortensen, Martin Bødtker, Kianoush, Sina, Tota-Maharaj, Rajesh, Cainzos-Achirica, Miguel·2017·JACC: Cardiovascular Imaging

DOI 10.1016/j.jcmg.2017.05.007

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Abstract

Quantification of coronary artery calcium (CAC) has been shown to be reliable, reproducible, and predictive of cardiovascular risk. Formal CAC scoring was introduced in 1990, with early scoring algorithms notable for their simplicity and elegance. Yet, with little evidence available on how to best build a score, and without a conceptual model guiding score development, these scores were, to a large degree, arbitrary. In this review, we describe the traditional approaches for clinical CAC scoring, noting their strengths, weaknesses, and limitations. We then discuss a conceptual model for developing an improved CAC score, reviewing the evidence supporting approaches most likely to lead to meaningful score improvement (for example, accounting for CAC density and regional distribution). After discussing the potential implementation of an improved score in clinical practice, we follow with a discussion of the future of CAC scoring, asking the central question: do we really need a new CAC score?

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Authors: Blaha, M. J., Mortensen, M. B., Kianoush, S., Tota-Maharaj, R., & Cainzos-Achirica, M.
Affiliations: Johns Hopkins University (US)
Corresponding author: Blaha, Michael J.
ORCID: Blaha, Michael J.
Mortensen, Martin Bødtker
Kianoush, Sina
Venue: JACC: Cardiovascular Imaging
Publisher: Elsevier BV
Published: 2017-08
Volume: 10
Issue: 8
Pages: 923-937
ISSN: 1876-7591 (ISSN-L)
1936-878X
DOI: 10.1016/j.jcmg.2017.05.007
OpenAlex: W2744127741
Cited by: 276
References: 59
Citations by year: 2026: 20 · 2025: 38 · 2024: 23 · 2023: 27 · 2022: 37 · 2021: 50 · 2020: 41 · 2019: 26 · 2018: 11 · 2017: 3
FWCI: 3.35
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 365 d)
Locations: JACC. Cardiovascular imaging (publishedVersion)
PubMed (publishedVersion)
Scopus (Elsevier) (submittedVersion)
Funders: American College of Cardiology Foundation
Topics: Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Keywords: coronary artery calcium scoring, calcium density, cardiovascular risk prediction, coronary artery calcification, coronary artery disease
MeSH terms: Computed Tomography Angiography, Algorithms, Coronary Artery Disease, Coronary Vessels, Decision Support Techniques, Humans, Predictive Value of Tests, Prognosis, Severity of Illness Index, Reproducibility of Results, Coronary Angiography, Vascular Calcification, Multidetector Computed Tomography

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