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ACCF/AHA 2007 Clinical Expert Consensus Document on Coronary Artery Calcium Scoring By Computed Tomography in Global Cardiovascular Risk Assessment and in Evaluation of Patients With Chest Pain
Preamble
Introduction
Consensus Statement Method
Introduction to CAC Measurement
Role of Risk Assessment in Cardiovascular Medicine
Matching Intensity of Intervention With Severity of Risk
Current Approaches to Global Risk Assessment and to Assessment of Incremental Risk Using New Tests
Risk Assessment for Coronary Heart Disease in Asymptomatic Populations
Prognosis by Coronary Artery Calcium Measurements
Theoretical Relationship Between Coronary Calcification and CHD Events
Approaches to Technology Assessment in CHD Screening
Systematic Reviews and Meta-Analyses
Data Quality Issues
Inclusion Criteria and Endpoint Definitions for the Present Analysis
Prognostic Value of CAC Scores From Published Reports From 2003–2005
Independent Prognostic Value of CAC Scores Over Cardiac Risk Factors
Predictive Accuracy in Patients With an Intermediate FRS
Future Research Needs
Summary
Role of CAC Scoring in Assessment of Symptomatic Patients
Diagnosis of Coronary Stenosis in Patients With Possible CHD by CAC
Comparison With Other Tests for CHD Diagnosis
Exercise ECG Test
Myocardial Perfusion Imaging and Stress Echocardiography
Other Uses of CAC Measurement in Symptomatic Persons
Summary
Use of Coronary CT for Assessment of Progression or Regression of Coronary Atherosclerosis
Biologic Relevance of Coronary Atherosclerosis Progression
Accuracy of Serial Coronary Calcium Assessments
Prognostic Relevance of CAC Score Changes
Modification of CAC Progression
Summary and Implications
Cost-Effectiveness of Coronary Calcium Scoring for Risk Assessment of Cardiac Death or MI
Summary and Conclusion
Special Considerations
CAC Scores and Gender
Epidemiology
Risk Assessment
Summary
Ethnicity
Chronic Kidney Disease (CKD) and End-Stage Renal Disease (ESRD)
Diabetes
Incidental Findings in Patients Undergoing CAC Testing
Summary and Final Conclusions
Staff
American College of Cardiology Foundation
REFERENCES
APPENDIX 1
WRITING COMMITTEE RELATIONSHIPS WITH INDUSTRY—ACCF/AHA 2007 CLINICAL EXPERT CONSENSUS DOCUMENT ON CORONARY ARTERY CALCIUM SCORING BY COMPUTED TOMOGRAPHY IN GLOBAL CARDIOVASCULAR RISK ASSESSMENT AND IN EVALUATION OF PATIENTS WITH CHEST PAIN
APPENDIX 2
PEER REVIEWER RELATIONSHIPS WITH INDUSTRY—ACCF/AHA 2007 CLINICAL EXPERT CONSENSUS DOCUMENT ON CORONARY ARTERY CALCIUM SCORING BY COMPUTED TOMOGRAPHY IN GLOBAL CARDIOVASCULAR RISK ASSESSMENT AND IN EVALUATION OF PATIENTS WITH CHEST PAIN