Division of Cardiology, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clin Cardiol. 2022 Nov;45(11):1107-1113. doi: 10.1002/clc.23918. Epub 2022 Sep 10.
Determining optimal candidates for the numerous potential pharmacotherapies for primary prevention of atherosclerotic cardiovascular disease remains challenging. Selective use of coronary artery calcium (CAC) scoring is recommended by the 2018 and 2019 American Heart Association/American College of Cardiology Cholesterol and Primary Prevention Guidelines as a tool for refining cardiovascular disease risk assessment. A growing body of research shows that CAC has potential value in allocation of primary prevention aspirin, determining blood pressure targets and treatment intensity, the intensity of cholesterol management, and use of the more expensive medications for type 2 diabetes. We also review the literature regarding very elevated CAC scores greater than 400 or 1000 and how these scores appear to confer a risk for cardiovascular disease on par with secondary prevention cohorts.
确定众多潜在的用于动脉粥样硬化性心血管疾病一级预防的药物治疗的最佳候选者仍然具有挑战性。2018 年和 2019 年美国心脏协会/美国心脏病学会胆固醇和一级预防指南建议选择性使用冠状动脉钙 (CAC) 评分作为一种工具，以细化心血管疾病风险评估。越来越多的研究表明，CAC 在心梗阿司匹林的一级预防中的分配、确定血压目标和治疗强度、胆固醇管理的强度以及 2 型糖尿病更昂贵药物的使用方面具有潜在价值。我们还回顾了关于 CAC 评分非常高（大于 400 或 1000）的文献，以及这些评分如何似乎与二级预防队列一样对心血管疾病的风险产生影响。
