Coronary Artery Calcium Scoring (CACS)

Most benefit in re-stratifying intermediate cardiac risk group either to a lower or higher risk category.

High risk category can then have appropriate cardiovascular investigations and definitive management.

Intermediate risk group:

  • Cardiac risk factors but no symptoms
  • 45-74 yr old men or  55-75 yr old women
  • No known coronary artery disease

Coronary calcium (AGATSTON) score looks at aggregate of all 4 main coronary arteries

Score > 100 indicates a moderately sized atherosclerotic plaque

Score > 400 indicates extensive plaque with almost guaranteed obstruction in one or more coronary arteries. This correlates well with coronary angiogram findings.

Scoring cannot determine the likelihood of plaque rupture

Low score (< 100) indicates absent or mild non-obstructive plaque

Links: 

CAC Position Statement

MESA CHD Risk Calculator

 

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