Coronary artery calcium score and coronary CT angiography enhance cardiovascular risk estimation and hold promise for guiding and monitoring personalized anti-atherosclerotic therapies.
Does the use of CACS and CCTA improve cardiovascular risk stratification and guide preventive therapy compared to clinical risk scores?
CACS and CCTA hold promise for enhancing cardiovascular risk estimation and guiding personalized preventive therapies such as lipid-lowering and antiplatelet treatments.
Currently, cardiovascular risk stratification to guide preventive therapy relies on clinical scores based on cardiovascular risk factors. However, the discriminative power of these scores is relatively modest. The use of coronary artery calcium score (CACS) and coronary CT angiography (CCTA) has surfaced as methods for enhancing the estimation of risk and potentially providing insights for personalized treatment in individual patients. CACS improves overall cardiovascular risk prediction and may be used to improve the yield of statin therapy in primary prevention, and possibly identify patients with a favorable risk/benefit relationship for antiplatelet therapies. CCTA holds promise to guide anti-atherosclerotic therapies and to monitor individual response to these treatments by assessing individual plaque features, quantifying total plaque volume and composition, and assessing peri-coronary adipose tissue. In this review, we aim to summarize current evidence regarding the use of CACS and CCTA for guiding lipid-lowering and antiplatelet therapy and discuss the possibility of using plaque burden and plaque phenotyping to monitor response to anti-atherosclerotic therapies.
Lima et al. (Mon,) conducted a review in Cardiovascular disease. Coronary artery calcium score (CACS) and coronary CT angiography (CCTA) vs. Clinical risk scores was evaluated. Coronary artery calcium score and coronary CT angiography enhance cardiovascular risk estimation and hold promise for guiding and monitoring personalized anti-atherosclerotic therapies.