Department of Cardiac Vascular Thoracic Sciences and Public Health, University of Padua.
Radiology Unit, Padua University Hospital, Padua.
Monaldi Arch Chest Dis. 2023 Sep 6;94(1). doi: 10.4081/monaldi.2023.2720.
Cardiac computed tomography angiography (CCTA) has emerged as a cost-effective and time-saving technique for excluding coronary artery disease. One valuable tool obtained by CCTA is the coronary artery calcium (CAC) score. The use of CAC scoring has shown promise in the risk assessment and stratification of cardiovascular disease. CAC scores can be complemented by plaque analysis to assess vulnerable plaque characteristics and further refine risk assessment. This paper aims to provide a comprehensive understanding of the value of the CAC as a prognostic tool and its implications for patient risk assessment, treatment strategies, and outcomes. CAC scoring has demonstrated superior ability in stratifying patients, especially asymptomatic individuals, compared to traditional risk factors and scoring systems. The main evidence suggests that individuals with a CAC score of 0 have a good long-term prognosis, while an elevated CAC score is associated with increased cardiovascular risk. Finally, the clinical power of CAC scoring and the development of new models for risk stratification could be enhanced by machine learning algorithms.
心脏 CT 血管造影 (CCTA) 已成为一种经济高效且省时的排除冠状动脉疾病的技术。CCTA 获得的一个有价值的工具是冠状动脉钙 (CAC) 评分。CAC 评分在心血管疾病的风险评估和分层中显示出了前景。CAC 评分可以通过斑块分析来补充，以评估易损斑块的特征并进一步细化风险评估。本文旨在全面了解 CAC 作为预后工具的价值及其对患者风险评估、治疗策略和结果的影响。与传统的危险因素和评分系统相比，CAC 评分在分层患者（尤其是无症状患者）方面表现出了优越的能力。主要证据表明，CAC 评分为 0 的个体具有良好的长期预后，而 CAC 评分升高与心血管风险增加相关。最后，通过机器学习算法，可以提高 CAC 评分的临床效能和开发新的风险分层模型。
