Evidence for Coronary Artery Calcification Screening in the Early Detection of Coronary Artery Disease and Implications of Screening in Developing Countries

Coronary artery disease (CAD) has become the biggest threat to population health all over the world. Although developed countries have witnessed a decline in CAD-related mortality in recent decades, developing countries are still experiencing steadily increasing CAD morbidity and mortality. Coronary artery calcification (CAC) is found to be a risk factor of CAD, and the use of CAC scanning may better predict CAD and improve evaluation and diagnosis of CAD. We review the major studies from developing countries investigating the prevalence and severity of CAC, the relationship of CAC and other conventional risk factors, the diagnostic accuracy of CAC computed tomography in relation to coronary angiography, and the predictive value of CAC scanning for future CAD events. Last, we summarize the recommendations on CAC scanning from several developing countries and propose future research topics about CAC.