[Early detection of myocardial infarct risk with cardio-CT. Can coronary calcium calculation prevention sudden cardiac death?].

The measurement of the calcium score with the cardio-CT is an option for determination of the individually elevated risk of a heart attack. In contrast to cardiac catheterization, the calcium score does not assess the coronary lumen, but rather the coronary vessel wall. Therefore, cardiac catheterization and calcium scoring are not competing but complementary tests: cardiac catheterization is performed to prove coronary stenoses, i.e. in patients with angina pectoris, while cardio-CT is used for the prognostic evaluation in asymptomatic patients. Cardio-CT should not be used to determine if cardiac catheterization should be performed. Also, in patients with angina pectoris, known coronary artery disease, s/p myocardial infarction or high absolute coronary risk, there is no indication for calcium scoring with cardio-CT. The prevailing indication for cardio-CT is detection of patients at high risk of a heart attack defined as > 2% annually. The recently presented St. Francis Heart Study has shown that calcium scoring provides a significantly higher prognostic value than the traditional Framingham score.