Coronary artery calcium in 2023: Guidelines for LDL-C goals, non-statin therapies, and aspirin use

Garshasb P Soroosh; Erfan Tasdighi; Rishav Adhikari; Michael J Blaha

doi:10.1016/j.pcad.2024.05.004

Coronary artery calcium in 2023: Guidelines for LDL-C goals, non-statin therapies, and aspirin use

Prog Cardiovasc Dis. 2024 May 15:S0033-0620(24)00072-0. doi: 10.1016/j.pcad.2024.05.004. Online ahead of print.

Authors

Garshasb P Soroosh¹, Erfan Tasdighi², Rishav Adhikari³, Michael J Blaha²

Affiliations

¹ Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: gsoroos1@jhmi.edu.
² Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

PMID: 38754533
DOI: 10.1016/j.pcad.2024.05.004

Abstract

Personalizing risk assessment and treatment decisions for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) rely on pooled cohort equations and increasingly coronary artery calcium (CAC) score. A growing body of evidence supports that elevated CAC scores correspond to progressively elevated ASCVD risk, and that scores of ≥100, ≥300, and ≥1000 denote risk that is equivalent to certain secondary prevention populations. This has led consensus guidelines to incorporate CAC score thresholds for guiding escalation of preventive therapy for lowering low-density lipoprotein cholesterol goals, initiation of non-statin lipid lowering medications, and use of low-dose daily aspirin. As data on CAC continues to grow, more decision pathways will incorporate CAC score cutoffs to guide management of blood pressure and cardiometabolic medications. CAC score is also being used to enrich clinical trial study populations for elevated ASCVD risk, and to screen for subclinical coronary atherosclerosis in patients who received chest imaging for other diagnostic purposes.

Keywords: ASCVD; Aspirin.; CAC; Lipid-lowering therapy.; Personalized medicine..

Publication types

Review