Coronary Artery Calcium Scanning Past, Present, and Future
Coronary Artery Calcium Scanning Past, Present, and Future
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DOI：
10.1016/j.jcmg.2015.02.006
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发表时间：
2015-05-01
影响因子：
14
通讯作者：
Hecht, Harvey S.
中科院分区：
文献类型：
--
作者：
Hecht, Harvey S.
冠状动脉钙扫描（CAC）已成为无症状一级预防人群中最可靠的冠状动脉事件预测指标，特别是在中危人群中。每一项研究都证明了其优于基于风险因素的范式，例如，Fragrance风险评分，基于结果的净重新分类指数范围为：中风险队列52.0%-65.6%，高风险队列34.0%-35.8%，低风险队列11.6%-15.0%。CAC改善了药物和生活方式的依从性，并且在特定人群中具有成本效益，能够有效地对治疗和扫描不同治疗策略和患者队列所需的数量进行分层。数据已经清楚地表明，与连续扫描CAC增加相关的预后更差，这表明评估剩余风险和治疗成功或失败的潜在作用。CAC也与中风和充血性心力衰竭的发展密切相关。(c)2015年由美国心脏病学会基金会。
Coronary artery calcium scanning (CAC) has emerged as the most robust predictor Of coronary events in the asymptomatic primary prevention population, particularly in the intermediate-risk cohort. Every study has demonstrated its superiority to risk factor-based paradigms, e.g., the Framingham Risk Score, with outcome-based net reclassification indexes ranging from 52.0% to 65.6% in the intermediate-risk, 34.0% to 35.8% in the high-risk, and 11.6% to 15.0% in the Low-risk cohorts. CAC improves medication and lifestyle adherence and is cost-effective in specified populations, with the ability to effectively stratify the number needed to treat and scan for different therapeutic strategies and patient cohorts. Data have emerged clearly demonstrating the worse prognosis associated with increasing CAC on serial scans, suggesting a potential role for evaluating residual risk and treatment success or failure. CAC is also strongly associated with the development of stroke and congestive heart failure. (c) 2015 by the American College of Cardiology Foundation.