Thompson Brad H, Stanford William
Department of Radiology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa Health Care, Iowa City, USA.
Int J Cardiovasc Imaging. 2005 Feb;21(1):39-53. doi: 10.1007/s10554-004-5343-9.
Coronary artery disease (CAD) is the number one killer of adults in the United States, claiming one-half million deaths annually. Early detection and prevention strategies clearly remain a top priority for health care providers in order to reduce the high mortality rate of heart disease. As an unequivocal reflection of arteriosclerosis, coronary arterial calcium (CAC) may provide a means to qualitatively assess the overall disease severity and likewise serve as a means to assess risk for CHD. It is known that patients with heavy calcium burdens have more advanced CAD, a concomitantly a higher likelihood of coronary stenoses, and a concomitant higher risk for acute cardiac events. Computed tomography has been shown to be an accurate, non-invasive method to quantify coronary calcification burden in patients. Evidence shows that calcium measurements by CT correlate well with histological plaque analyses, and that CAC measurements accurately reflect disease severity and can be useful to assess individual risk for CHD. The purpose of this article is to summarize the currently available evidence that has attempted to validate CAC screening as a screening exam and risk predictor for coronary heart disease.
冠状动脉疾病（CAD）是美国成年人的头号杀手，每年导致50万人死亡。为了降低心脏病的高死亡率，早期检测和预防策略显然仍然是医疗保健提供者的首要任务。作为动脉粥样硬化的明确反映，冠状动脉钙化（CAC）可能提供一种定性评估整体疾病严重程度的方法，同样也可作为评估冠心病风险的手段。众所周知，钙负荷重的患者患有更晚期CAD，同时冠状动脉狭窄的可能性更高，以及急性心脏事件的风险更高。计算机断层扫描已被证明是一种准确、无创的方法，用于量化患者的冠状动脉钙化负担。证据表明，CT测量的钙与组织学斑块分析相关性良好，并且CAC测量准确反映疾病严重程度，可用于评估个体患冠心病的风险。本文的目的是总结目前现有的证据，这些证据试图验证CAC筛查作为冠心病的筛查检查和风险预测指标。
