Coronary artery calcium score: pivotal role as a predictor for detecting coronary artery disease in symptomatic patients

Abstract

Chest pain and dyspnea are common presentations for symptomatic individuals with suspected CAD in the primary care office and cardiology clinics. However, it is imperative to properly diagnose who should undergo further evaluation for cardiac etiologies of chest pain, with either non-invasive or invasive imaging tests. The purpose of this review is to highlight the role of coronary artery calcium (CAC) score as a screening tool for symptomatic patients to detect CAD. The purpose of CAC scoring is to establish the presence and severity of coronary atherosclerosis and can play a vital role in symptomatic patients. The use of CAC testing in symptomatic patients has traditionally been limited due to fundamental concerns including the occurrence of coronary calcification relatively late in the atherosclerotic process and high prevalence of CAC in the population.Further issue relate to its low specificity for obstructive CAD, as well as demonstration of significant ethnic variability in plaque composition and calcification patterns.CAC testing as gained attention as an inexpensive, rapid, reproducible and a safe alternative to exclude CAD in symptomatic patients and defer further invasive imaging tests. This paper will review the available literature in regards to use of CAC in symptomatic populations. Introduction:Coronary artery disease (CAD) is a leading cause of cardiovascular mortality accounting for 42.6% of all such deaths followed by stroke (17%).(1) For the past few decades, the pretest probability (PTP) of obstructive CAD was assessed based upon symptom presentation and known cardiovascular (CV) risk factors such as hypertension, hyperlipidemia, family history of CAD, and

Coronary Artery Calcium Score - A Reliable Indicator of Coronary Artery Disease?

“…In both developed and developing countries, CAD is responsible for one-third of mortality among persons over 35, with the percentage in Western countries nearing 50 percent [ 2 ]. Although there is an equal susceptibility of CAD in men and women, women tend to have a better risk profile at a younger age and vice-versa in old age [ 3 ]. Pre-test probability (PTP) of obstructive CAD has been determined for several decades based on symptom presentation and recognized cardiovascular (CV) risk factors such as hypertension, hyperlipidemia, family history, and smoking.…”