CT calcium scoring

1. Definition
   1. CT-based quantification of coronary calcium deposits
   2. Calcium deposits correlate with atherosclerotic Plaque
2. Indications
   1. CAD Risk stratification of asymptomatic patients
      1. Intermediate risk patients who have not undergone stress testing
      2. Intermediate risk patients with equivocal stress testing
3. Efficacy
   1. Calcium scoring is an indepedent predictor of CAD event
   2. Calcium score does not predict focal stenosis severity
4. Equipment
   1. Electron beam tomography or
   2. Multidetector CT
5. Interpretation
   1. Calcium Score 0: Low risk
   2. Calcium Score 1-100: CAD event Relative Risk = 2.1
   3. Calcium Score 101-400: CAD event Relative Risk = 3.1
      1. Threshold indicating further evaluation with stress testing
   4. Calcium Score 401-1000: CAD event Relative Risk = 4.6
   5. Calcium Score >1000: CAD event Relative Risk = 8.3
6. References
   1. Budoff (2003) J Am Coll Cardiol 42:1867-78
   2. Pletcher (2004) Arch Intern Med 164:1285-92