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Ron Blankstein,Ankur Gupta,Jamal S. Rana,Khurram Nasir 대한내분비학회 2017 Endocrinology and metabolism Vol.32 No.1
Over the last two decades coronary artery calcium (CAC) scanning has emerged as a quick, safe, and inexpensive method to detectthe presence of coronary atherosclerosis. Data from multiple studies has shown that compared to individuals who do not have anycoronary calcifications, those with severe calcifications (i.e., CAC score >300) have a 10-fold increase in their risk of coronary heartdisease events and cardiovascular disease. Conversely, those that have a CAC of 0 have a very low event rate (~0.1%/year), withdata that now extends to 15 years in some studies. Thus, the most notable implication of identifying CAC in individuals who do nothave known cardiovascular disease is that it allows targeting of more aggressive therapies to those who have the highest risk of havingfuture events. Such identification of risk is especially important for individuals who are not on any therapies for coronary heartdisease, or when intensification of treatment is being considered but has an uncertain role. This review will highlight some of the recentdata on CAC testing, while focusing on the implications of those findings on patient management. The evolving role of CAC inpatients with diabetes will also be highlighted.