CAC and CHD

Q: All of the following are associated with the early development of Coronary Heart Disease (CHD) after a positive Coronary Artery Calcium Score (CAC). Comparing all of the following, which is considered a relatively lesser risk factor for CHD to assess via CAC? - select one

A) diabetes 

B) smoking

C) hypertension

D) dyslipidemia

E) family history

Answer: A

"Calcium Scoring" has gained immense popularity in predicting coronary artery disease in recent years. In normal individuals, a 10-year atherosclerotic cardiovascular disease (ASCVD) risk is determined depending on the CAC score. However, patients with hypertension, dyslipidemia, and family history can develop the disease within 3.3 to 4.3 years of a positive CAC score.

Patients with diabetes though also develop CHD early, but it takes about 6.4 years after positive CAC. Males with diabetes should be checked within 35-38 years, and females between 49-52 years - for CAC scoring.

Generally, for a normal individual without risk factors, it should be done between 41-44 years in males and 56-60 years in females.

#cardiology

Reference:

Erbel R, Möhlenkamp S, Moebus S, et al. Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall study. J Am Coll Cardiol 2010; 56:1397.