Editorial

Adding calcium scoring to myocardial perfusion imaging: Does it alter physicians’ therapeutic decision making?

This expert consensus statement summarizes the available data regarding the prognostic value of CAC in the asymptomatic population and its ability to refine individual risk prediction, addresses the limitations identified in the current traditional risk factor-based treatment strategies recommended by the 2013 ACC/AHA Prevention guidelines including use of the Pooled Cohort Equations (PCE), and the US Preventive Services Task Force (USPSTF) Recommendation Statement for Statin Use for the Primary Prevention of Cardiovascular Disease in Adults. It provides CAC based treatment recommendations both within the context of the shared decision making model espoused by the 2013 ACC/AHA Prevention guidelines and independent of these guidelines.

Over the past decade, significant strides have been made in advanced non-invasive cardiac imaging. Technological advances in both hardware and software applications have made direct visualization of atherosclerotic plaque a reality. These advances have come at a crucial time, and help to fill a gap in contemporary diagnostic modalities, which have additionally translated to refining cardiovascular prognosis. In this chapter, the utility and application of arterial ultrasound, coronary computed tomography, cardiac magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography will be discussed.