Highlights
- •Primary prevention of cerebrovascular disease (CVA) is crucial.
- •Coronary artery calcification (CAC) is a risk factor for predicting CVA events.
- •CAC may have little power for risk discrimination of incident CVA events.
- •A high CAC score and/or carotid artery plaques support preventive therapy.
- •The CAC score will play an important role in the management of CVA prediction.
Abstract
Cerebrovascular disease (CVA) is one of the most prevalent causes of death and disability
in the United States, and its primary prevention is crucial. For the primary prevention
of CVA, it is commonly recommended that all adults should initially undergo an office-based
traditional risk assessment using established predictive models, such as the Framingham
Stroke Profile Score or the atherosclerotic cardiovascular disease (ASCVD) risk calculator
from the American College of Cardiology/American Heart Association (ACC/AHA). Coronary
artery calcification (CAC) is an independent risk predictor of cardiovascular disease
(CVD), which often includes CVA. A CAC score can improve discrimination for CVD in
the general population beyond established risk prediction tools. Several recent major
prospective studies have assessed the use of CAC data to predict CVA events in asymptomatic
patients. The CAC score itself is a reliable independent risk factor for predicting
CVA events after adjusting for traditional risk factors. Regarding discriminative
value, there is little value afforded by the addition of the CAC score to current
CVA risk prediction tools. In this review, we summarize the current key literature
regarding the CAC score and CVA. We focus on its diagnostic value in identifying patients
at risk and the utility of the CAC score for stratification of individuals.
Keywords
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Article Info
Publication History
Published online: January 14, 2017
Accepted:
January 12,
2017
Received in revised form:
November 29,
2016
Received:
September 12,
2016
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
