The application and clinical utility of visual coronary artery calcium evaluation on routine chest computed tomography for cardiac risk stratification: NOT a poor man’s calcium score

Currently, coronary artery disease (CAD) forms a major health issue and economic burden on healthcare systems, which is expected to grow exponentially in future years. Simultaneously, there is a rising need for using simple clinically available and low-cost information on cardiac risk factors. Recent studies have shown that patients’ coronary artery calcium (CAC) extent can be equally well evaluated on routine non-cardiac (non-ECG gated) computed tomography (CT) of the chest that have been previously performed, for non-cardiac disease evaluation (e.g. lungcancer). The simple visual evaluation of patients’ CAC-extent on cost-free available chest CT could therefore play an important role, especially in low-resource healthcare settings or when reimbursement transitions to value-based models. This thesis aimed to demonstrate the evident clinical value of evaluating CAC on available chest CT for cardiac risk stratification. Ultimately the conclusion could be made that, when this method is incorporated in the standard practice of cardiology, cardiac risk stratification for CAD will be enhanced and specifically tailored to the patient. This method is time-efficient and will increase the diagnostic yield of dedicated cardiac imaging. Ultimately, this can lead to a reduction in test-burden for patients and a coinciding reduction in health care expenses for health care systems.<br>