Cardiovascular risk factor-scoring algorithms may fall short in identifying asymptomatic individuals who will subsequently suffer a coronary event. It is generally thought that evaluation of the extent of the atherosclerotic plaque and total plaque burden can improve cardiovascular risk stratification. In the last decade, there has been an increasing interest in coronary calcium scoring by computed tomography. By determining the calcium score, an estimate of the total amount of coronary plaque is obtained. Numerous studies have shown that the calcium score predicts coronary heart disease. Recently, the calcium score was shown to improve risk stratification beyond cardiovascular risk factors, especially in those individuals deemed to be at intermediate risk. So far, only limited data exist on the cost-effectiveness of coronary calcium scoring in asymptomatic populations.
*Department of Radiology, University of Groningen/University Medical Center Groningen, Center for Medical Imaging—North East Netherlands, The Netherlands
†Department of Cardiology, Medical University of South Carolina, Charleston, SC
Dr P.B. Morris has served on the speakers’ bureau of Abbott and Merck. The other author declares no conflicts of interest.
Reprints: Rozemarijn Vliegenthart, MD, PhD, Department of Radiology, University of Groningen/University Medical Center Groningen, Center for Medical Imaging—North East Netherlands, Hanzeplein 1, 9713 GZ Groningen, The Netherlands (e-mail: firstname.lastname@example.org).