TY - JOUR
T1 - Extra-coronary Calcification and Cardiovascular Events
T2 - What Do We Know and Where Are We Heading?
AU - Anugula, Dixitha
AU - Cardoso, Rhanderson
AU - Grandhi, Gowtham R.
AU - Blankstein, Ron
AU - Nasir, Khurram
AU - Al-Mallah, Mouaz
AU - Shah, Dipan J.
AU - Cainzos-Achirica, Miguel
N1 - Funding Information:
Dr. Khurram Nasir is on the advisory board of Amgen, Novartis, and Novo Nordisk. His research is partly supported by the Jerold B. Katz Academy of Translational Research. The other authors declare that they have no conflicts of interest relevant to the content of this manuscript.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/10
Y1 - 2022/10
N2 - PURPOSE OF REVIEW: The coronary artery calcium score is a guideline-endorsed aid for further risk stratification in the primary prevention of atherosclerotic cardiovascular disease. The non-contrast scan performed for detection of coronary artery calcium also gives an opportunity to visualize calcifications in the thoracic aorta and in the heart valves, at no additional cost or radiation exposure. The purpose of this review was to discuss the potential clinical value of measuring thoracic aortic calcification, aortic valve calcification, and mitral annulus calcification.RECENT FINDINGS: After two decades of active research, all three calcifications have been extensively evaluated, across various cohorts. We discuss classic and recent studies, current knowledge gaps, and future directions in this space. The added value of these measurements has traditionally been considered modest at best, and they are not currently discussed in relevant primary prevention guidelines in North America and Europe. However, recent studies evaluating high thoracic calcification thresholds and younger populations have further enriched this space. Specifically, some studies suggest that detection of severe thoracic aortic calcification may be helpful in further risk assessment and that detection of aortic valve calcifications may have important prognostic implications in younger individuals. Although more research is needed, particularly in larger young-to-middle-aged cohorts, future guidelines might consider including these features as risk-enhancing factors.
AB - PURPOSE OF REVIEW: The coronary artery calcium score is a guideline-endorsed aid for further risk stratification in the primary prevention of atherosclerotic cardiovascular disease. The non-contrast scan performed for detection of coronary artery calcium also gives an opportunity to visualize calcifications in the thoracic aorta and in the heart valves, at no additional cost or radiation exposure. The purpose of this review was to discuss the potential clinical value of measuring thoracic aortic calcification, aortic valve calcification, and mitral annulus calcification.RECENT FINDINGS: After two decades of active research, all three calcifications have been extensively evaluated, across various cohorts. We discuss classic and recent studies, current knowledge gaps, and future directions in this space. The added value of these measurements has traditionally been considered modest at best, and they are not currently discussed in relevant primary prevention guidelines in North America and Europe. However, recent studies evaluating high thoracic calcification thresholds and younger populations have further enriched this space. Specifically, some studies suggest that detection of severe thoracic aortic calcification may be helpful in further risk assessment and that detection of aortic valve calcifications may have important prognostic implications in younger individuals. Although more research is needed, particularly in larger young-to-middle-aged cohorts, future guidelines might consider including these features as risk-enhancing factors.
KW - Calcifications
KW - Cardiovascular disease
KW - Computed tomography
KW - Imaging
KW - Primary prevention
KW - Risk assessment
KW - Calcium
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Aortic Valve Stenosis
KW - Coronary Artery Disease/diagnostic imaging
KW - Vascular Calcification/diagnostic imaging
KW - Calcinosis/diagnostic imaging
KW - Aortic Valve/diagnostic imaging
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U2 - 10.1007/s11883-022-01051-5
DO - 10.1007/s11883-022-01051-5
M3 - Review article
C2 - 36040566
AN - SCOPUS:85136856883
SN - 1523-3804
VL - 24
SP - 755
EP - 766
JO - Current Atherosclerosis Reports
JF - Current Atherosclerosis Reports
ER -