Coronary artery calcium scans - Debate continues

THE question of when to initiate preventive strategies in asymptomatic patients at intermediate risk of cardiovascular disease is a vexing one.

Proponents of the CT scanning technique, coronary artery calcium (CAC) scoring, say the approach is clinically useful for these very patients.

They say CAC scores can help stratify patients at intermediate risk who could benefit from more frequent monitoring or, more controversially, pharmacological interventions such as statins.

But the debate over CAC scoring is anything but settled. Sceptics have raised concerns about whether interventions based on CAC scores actually benefit patients.

Backed by emerging data as well as technological advances such as the latest-generation CT scanners and new scoring techniques that reduce the radiation exposure needed to obtain a person’s CAC score, advocates say the approach warrants broader use.

Interventional cardiologist Dr Daniel Friedman