Division of Cardiology, Department of Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USA.
Division of Cardiology, Department of Medicine, Los Angeles Biomedical Research Institute, 1124 W Carson Street, Bldg RB-2, Torrance, CA 90502-2064, USA.
Ther Adv Cardiovasc Dis. 2021 Jan-Dec;15:17539447211051248. doi: 10.1177/17539447211051248.
Atherosclerotic cardiovascular disease (ASCVD) is a common disease among the general population, and includes four major areas: (1) coronary heart disease (CHD), manifested by stable angina, unstable angina, myocardial infarction (MI), heart failure, and coronary death; (2) cerebrovascular disease, manifested by transient ischemia attack and stroke; (3) peripheral vascular disease, manifested by claudication and critical limb ischemia; and (4) aortic atherosclerosis and aortic aneurysm (thoracic and abdominal). CHD remains the leading cause of death for both men and women in the United States. So, it is imperative to identify people at risk of CHD and provide appropriate medical treatment or intervention to prevent serious complications and outcomes including sudden cardiac death. Coronary artery calcification (CAC) is a marker of subclinical coronary artery disease. Therefore, coronary artery calcium score is an important screening method for Coronary artery disease (CAD). In this article, we performed a comprehensive review of current literatures and studies assessing the prognostic value of CAC for future cardiovascular disease (CVD) events. We searched PubMed, MEDLINE, Google Scholar, and Cochrane library. We also reviewed the 2018 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the assessment of CVD risk. A CAC score of zero corresponds to very low CVD event rates (∼1% per year) and hence a potent negative risk marker. This has been referred to as the 'power of zero' and affords the lowest risk of any method of risk calculation. It is now indicated in the 2018 ACC/AHA Cholesterol guidelines to be used to avoid statins for 5-10 years after a score of zero, and then re-assess the patient.
动脉粥样硬化性心血管疾病（ASCVD）是一种常见的普通人群疾病，包括四个主要领域：（1）冠心病（CHD），表现为稳定型心绞痛、不稳定型心绞痛、心肌梗死（MI）、心力衰竭和冠状动脉死亡；（2）脑血管疾病，表现为短暂性脑缺血发作和中风；（3）外周血管疾病，表现为跛行和临界肢体缺血；（4）主动脉粥样硬化和主动脉瘤（胸和腹）。冠心病仍然是美国男女死亡的主要原因。因此，识别有 CHD 风险的人群并提供适当的医疗治疗或干预措施以预防严重并发症和结局，包括心源性猝死，是当务之急。冠状动脉钙化（CAC）是亚临床冠状动脉疾病的标志物。因此，冠状动脉钙评分是冠心病（CAD）的重要筛查方法。在本文中，我们对评估 CAC 对未来心血管疾病（CVD）事件的预后价值的当前文献和研究进行了全面回顾。我们搜索了 PubMed、MEDLINE、Google Scholar 和 Cochrane 图书馆。我们还回顾了 2018 年美国心脏病学会（ACC）/美国心脏协会（AHA）关于 CVD 风险评估的指南。CAC 评分为零对应于非常低的 CVD 事件发生率（每年约 1%），因此是一种强大的阴性风险标志物。这被称为“零的力量”，并提供了任何风险计算方法中最低的风险。它现在被列入 2018 年 ACC/AHA 胆固醇指南，用于在评分零后 5-10 年内避免他汀类药物，然后重新评估患者。
