Coronary Artery Calcification Screening

Abstract

Computed tomography (CT) has been proposed as a tool for routine screening for coronary artery calcification (CAC) in asymptomatic individuals as part of a comprehensive risk assessment. A national survey in the United States reported that approximately 27% of diagnostic radiologists already read CAC CT screening scans regularly, making it the most common type of CT screening currently performed in the United States.¹The Screening for Heart Attack Prevention and Education (SHAPE) guidelines recommend screening of all asymptomatic men 45 to 75 years of age and asymptomatic women 55 to 75 years of age except those defined as very low risk.² Such screening in the United States could involve tens of millions of individuals. However, the benefits from this type of screening have not yet been demonstrated directly in randomized trials with cardiovascular events or mortality as an end point, but it has been suggested that the use of CAC scoring can detect disease in asymptomatic persons who would be at low risk when assessed by traditional risk factors.³ However, the potential risks of screening, including the risk of radiation-induced cancer, have to be considered along with the potential benefits.