Coronary calcium measurement

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Coronary Artery Calcium Scoring By Computed Tomography.

It is possible to measure or estimate calcification in the coronary arteries by techniques including fast CT scanning.

The place of this investigation and its reproducibility[1]is as yet unclear.

It is not recommended as a screening test in asymptomatic people and indeed the evidence base suggests it may only help in risk stratification of high risk populations identified by other means[2] or [3]. Presently it is used as a case study in health economics where ability to measure something expensively with a radiation exposure does not cope well with sensitivity and specificity issues acceptable in a much cheaper diagnostic test with less risk of harm[4][5]

It is unclear what, if anything, should be done as a result of noting coronary calcification in an asymptomatic individual.

This article is a work in progress. Please feel free to contribute to it.


References

  1. Rutten A, Isgum I, Prokop M. Coronary calcification: effect of small variation of scan starting position on Agatston, volume, and mass scores. Radiology. 2008 Jan; 246(1):90-8.(Link to article – subscription may be required.)
  2. Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, Lauer MS, Post WS, Raggi P, Redberg RF, Rodgers GP, Shaw LJ, Taylor AJ, Weintraub WS. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography) developed in collaboration with the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography. Journal of the American College of Cardiology. 2007 Jan 23; 49(3):378-402.(Link to article – subscription may be required.)
  3. Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, Lauer MS, Post WS, Raggi P, Redberg RF, Rodgers GP, Shaw LJ, Taylor AJ, Weintraub WS, Harrington RA, Abrams J, Anderson JL, Bates ER, Grines CL, Hlatky MA, Lichtenberg RC, Lindner JR, Pohost GM, Schofield RS, Shubrooks SJ, Stein JH, Tracy CM, Vogel RA, Wesley DJ. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography). Circulation. 2007 Jan 23; 115(3):402-26.(Link to article – subscription may be required.)
  4. Min JK, Shaw LJ, Berman DS. Cost-effective applications of cardiac computed tomography in coronary artery disease. Expert review of cardiovascular therapy. 2008 Jan; 6(1):43-55.(Link to article – subscription may be required.)
  5. Waugh N, Black C, Walker S, McIntyre L, Cummins E, Hillis G. The effectiveness and cost-effectiveness of computed tomography screening for coronary artery disease: systematic review. Health technology assessment (Winchester, England). 2006 Oct; 10(39):iii-iv, ix-x, 1-41.
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