Beyond the Agatston calcium score: role of calcium density and other calcified plaque markers for cardiovascular disease prediction.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Opinion in Cardiology Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI:10.1097/HCO.0000000000001185

Alexander C Razavi, Seamus P Whelton, Roger S Blumenthal, Michael J Blaha, Omar Dzaye

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引用次数: 0

Abstract

Purpose of review: To review the current evidence and highlight future strategies regarding consideration of coronary artery calcium (CAC) density in cardiovascular disease (CVD) risk stratification.

Recent findings: Expressed as the product of plaque area and a peak calcium density weighting factor, the Agatston method is the gold-standard for measuring CAC on noncontrast cardiac computed tomography. Over the last decade, observational data have suggested that calcium density is inversely associated with CVD events and confers additional prognostic information independent of traditional risk factors and Agatston CAC scores. Specific density measures have been assessed including peak calcium density, mean CAC density, and CAC area-density discordance. Beyond calcium density, the number of affected arteries and regional distribution of CAC which may be correlated with CAC density have also improved the predictive utility of the Agatston score.

Summary: Calcium density is inversely associated with CVD risk after considering plaque area and/or volume. Calcium markers including density, vessel involvement, and regional distribution confer additional prognostic information for the prediction of incident CVD among those with prevalent subclinical atherosclerosis. A future area of study includes calcium radiomics ('calcium-omics') and whether the artificial intelligence-derived automated measurement of calcium markers beyond the Agatston score may be of value in CVD risk stratification among individuals with early to advanced subclinical atherosclerosis.

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超越阿加特斯通钙评分：钙密度和其他钙化斑块标记在心血管疾病预测中的作用。

综述目的：回顾目前的证据，并强调在心血管疾病（CVD）风险分层中考虑冠状动脉钙（CAC）密度的未来策略：阿加斯顿法是非对比心脏计算机断层扫描测量冠状动脉钙密度的黄金标准，用斑块面积与钙密度峰值加权因子的乘积表示。在过去的十年中，观察性数据表明，钙密度与心血管疾病事件成反比，并能在传统的风险因素和阿加斯顿 CAC 评分之外提供额外的预后信息。已评估的具体密度指标包括峰值钙密度、平均 CAC 密度和 CAC 面积-密度不一致性。除了钙密度外，受影响动脉的数量和 CAC 的区域分布（可能与 CAC 密度相关）也提高了 Agatston 评分的预测效用。摘要：在考虑斑块面积和/或体积后，钙密度与心血管疾病风险成反比。包括密度、血管参与度和区域分布在内的钙标志物为预测亚临床动脉粥样硬化患者的心血管疾病事件提供了额外的预后信息。未来的研究领域包括钙放射组学（"钙组学"），以及人工智能自动测量阿加特斯通评分以外的钙标记物是否对早期至晚期亚临床动脉粥样硬化患者的心血管疾病风险分层有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Cardiology 医学-心血管系统

CiteScore

4.20

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.