Progression of coronary artery calcification at the crossroads: sign of progression or stabilization of coronary atherosclerosis?

Coronary artery calcification (CAC) has been strongly established as an independent predictor of adverse events, with a significant incremental prognostic value over traditional risk stratification algorithms. CAC progression has been associated with a higher rate of events. In parallel, several ran...

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Published inCardiovascular diagnosis and therapy Vol. 6; no. 3; pp. 250 - 258
Main Authors Rodriguez-Granillo, Gaston A, Carrascosa, Patricia, Bruining, Nico
Format Journal Article
LanguageEnglish
Published China (Republic : 1949- ) AME Publishing Company 01.06.2016
Subjects
Mini-Review
Prognostic value
atherothrombosis
statin
imaging
longitudinal studies
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Summary:Coronary artery calcification (CAC) has been strongly established as an independent predictor of adverse events, with a significant incremental prognostic value over traditional risk stratification algorithms. CAC progression has been associated with a higher rate of events. In parallel, several randomized studies and meta-analysis have shown the effectiveness of statins to slow progression and even promote plaque regression. However, evidence regarding the effect of routine medical therapy on CAC has yielded conflicting results, with initial studies showing significant CAC regression, and contemporaneous data showing rather the opposite. Accordingly, there is currently a great controversy on whether progression of CAC is a sign of progression or stabilization of coronary artery disease (CAD). The finding of inexorable CAC progression despite the implementation of intensive contemporaneous medical therapy suggests that further understanding of this phenomenon should be undertaken before the implementation of CAC as a surrogate endpoint for longitudinal studies, or for prospective follow-up of patients under routine medical treatment.
Bibliography:Contributions: (I) Conception and design: All authors; (II) Administrative support: None; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.
ISSN:2223-3652
2223-3660
DOI:10.21037/cdt.2016.03.03