Use of coronary artery calcium score and coronary CT angiography to guide cardiovascular prevention and treatment.

IF 2.6 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Maria Rita Lima, Pedro M Lopes, António M Ferreira
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引用次数: 0

Abstract

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.

利用冠状动脉钙化评分和冠状动脉 CT 血管造影术指导心血管疾病的预防和治疗。
目前,指导预防性治疗的心血管风险分层依赖于基于心血管风险因素的临床评分。然而,这些评分的判别能力相对较弱。冠状动脉钙化评分(CACS)和冠状动脉 CT 血管造影术(CCTA)的使用已成为提高风险估计的方法,并有可能为个体患者的个性化治疗提供见解。CACS 可改善整体心血管风险预测,可用于提高一级预防中他汀类药物治疗的收益,并有可能识别出抗血小板疗法风险/收益关系良好的患者。通过评估斑块的个体特征、量化斑块的总体积和组成以及评估冠状动脉周围脂肪组织,CCTA 有望指导抗动脉粥样硬化疗法并监测个体对这些疗法的反应。在这篇综述中,我们旨在总结有关使用 CACS 和 CCTA 指导降脂和抗血小板治疗的现有证据,并讨论使用斑块负荷和斑块表型监测抗动脉粥样硬化治疗反应的可能性。
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来源期刊
Therapeutic Advances in Cardiovascular Disease
Therapeutic Advances in Cardiovascular Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.50
自引率
0.00%
发文量
11
审稿时长
9 weeks
期刊介绍: The journal is aimed at clinicians and researchers from the cardiovascular disease field and will be a forum for all views and reviews relating to this discipline.Topics covered will include: ·arteriosclerosis ·cardiomyopathies ·coronary artery disease ·diabetes ·heart failure ·hypertension ·metabolic syndrome ·obesity ·peripheral arterial disease ·stroke ·arrhythmias ·genetics
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