Asymptomatic patients at low or high risk of cardiovascular disease do not benefit from coronary calcium measurements. However, these measurements may benefit asymptomatic, intermediate-risk patients by refining the risk assessment and prompting lifestyle changes and pharmacologic therapy. Coronary calcium measurements may be reasonable in some symptomatic patients, especially to determine the etiology of cardiomyopathy, to assess patients who have equivocal treadmill or functional test results, and to assess patients with chest pain who have equivocal or normal echocardiography findings and negative cardiac enzyme test results.
Research is lacking on the use of serial cardiac CT in assessing subclinical atherosclerosis over time and in detecting noncalcified plaque, although further evidence is emerging. Research is also ongoing to determine the benefit of hybrid scanning in assessing cardiovascular risk and in detecting obstructive disease.
