Coronary Artery Calcium Score; Could it help personalize statin use? | ||
| The Egyptian Journal of Hypertension and Cardiovascular Risk | ||
| Article 4, Volume 15, Issue 1, March 2024 PDF (372.99 K) | ||
| Document Type: Mini Review Article | ||
| DOI: 10.21608/tejhcr.2025.360905.1004 | ||
| Author | ||
| Salma Ahmed Essam AbouEl Naga* | ||
| Cardiology Department, Cairo University | ||
| Abstract | ||
| Statins, which decrease low-density lipoprotein cholesterol (LDL-C), have a pivotal role in preventing atherosclerotic cardiovascular disease. The decision to initiate statin therapy is often based on population-based risk calculators which may overestimate or underestimate the individual risk Coronary artery calcium score (CACS) is a specific marker of coronary atherosclerotic burden that can be used to measure calcified subclinical atherosclerosis and consequently is important in cardiovascular risk stratification. CACS a non-invasive imaging modality, which has aroused as a powerful tool to refine risk assessment and personalize statin therapy. The CAC score is used for guiding the use of statins in intermediate risk patients or borderline risk , in which statin use is uncertain. CAC scoring can reclassify risk in this group, guiding starting statin therapy. There is a clear association between higher calcium density and lower risk of cardiovascular events using CT assessment of coronary artery calcium. This could be explained that when the proportion and density of calcium increases within the plaque, the plaque is stabilized and thereby reducing the risk of acute cardiovascular events and plaque rupture. An important limitation is that no studies have evaluated the impact of preventive interventions guided by calcium scores on hard event outcomes as well as coronary calcium score cannot exclude the presence of noncalcified atherosclerotic plaque, which often is more unstable and liable to rupture. CACS can be a powerful tool for personalizing statin therapy in intermediate- and borderline-risk patients. CACS refines risk assessment, guides statin therapy and improves patient engagement. | ||
| Keywords | ||
| Cardiovascular risk assessment; Primary Prevention; Atherosclerosis; Cardiac CT; Preventive Cardiology | ||
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