Even though coronary artery calcification (Agatston Score) has been determined as an independent risk factor for cardiovascular disease, I do not usually see this part of workup for anything. Thus, can someone shed some light in this matter?
Dear Dr. Banerjee.
Actually that´s a good point you´ve raised. The Agatston score has an already settled value in asymptomatic patients or without known coronary artery disease. However in patients with already diagnosed CAD or in the ones with an acute MI, its prognostic value is still obscure.
Although it´s reasonable to infer that the higher the Agatston score is, the worst the prognostic may be in patients with coronary angiogram showing obstructive plaques, this assumption may be misleading.
To reinforce this idea, a few days ago Puri et. al. (J Am Coll Cardiol 2015; 65:1273-1282) published a beautiful research stating that statin therapy reduces atheroma volume but increases calcification of the plaques, proving the latest assumption to be wrong.
This question you raised is a good one for a paper, and perhaps the finding may surprise us.
Dr. Modolo, thank you for the response and reference to the wonderful article. That is helpful.
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