{"id":"8ccc0d7c84f0","type":"article","url":"https://hartvaat.nl/2026/09/09/combinatie-van-cac-score-volume-en-dichtheid-verbetert-risicoschatting/","title":"Combinatie van CAC-score, volume en dichtheid verbetert risicoschatting","title_en":"Coronary Calcification: A Nuanced View.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog"],"tags":[],"journal":"Cardiology in review","doi":"10.1097/CRD.0000000000001449","source_url":"https://doi.org/10.1097/CRD.0000000000001449","authors":["Yeru Zhao","Ziyi Xu","Chongfu Jia"],"significance":5,"published":"2026-09-17","source_date":"2026-09-09","image":"https://hartvaat.nl/global/img/6e2cc0469790.webp","kennis":["https://hartvaat.nl/kennis/lipiden/lp-a-verhoogd/","https://hartvaat.nl/kennis/lipiden/lipidenmedicatie-bij-ckd/"],"congress":"","summary_en":"This narrative review examines the prognostic value and interrelationships of quantitative coronary artery calcification (CAC) indicators, including the CAC score, volume, and density. While the traditional CAC score positively correlates with major adverse cardiovascular events, high calcification density exerts a protective effect, particularly during statin therapy, though this benefit diminishes when volume exceeds 130 mm³. Distinct risk factors drive volume versus density progression. Integrating multiple CAC parameters rather than relying on a single score can enhance cardiovascular risk prediction in clinical practice.","created":"2026-09-10T01:22:29Z","updated":"2026-09-10T01:22:30Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze narratieve review belicht de prognostische waarde en onderlinge samenhang van kwantitatieve coronacalcificatie-indicatoren zoals de CAC-score, volume en dichtheid. Hoewel de traditionele CAC-score positief correleert met MACE, werkt een hoge calcificatiedichtheid beschermend tegen cardiovasculaire events, vooral bij statinatherapie; dit effect verdwijnt echter bij een volume >130 mm³. Verschillende risicofactoren beïnvloeden volume en dichtheid op verschillende manieren. Combinatie van deze parameters in plaats van een enkele score kan de risicoschatting voor cardiologen verfijnen.","abstract_original":"Coronary artery calcification (CAC) is a marker of atherosclerosis. Various quantitative indicators, such as CAC score (CACS) and CAC volume, are associated with the risk of major adverse cardiovascular events (MACE), whereas CAC density has a protective effect. However, the interrelationships among these indicators and their respective risk factors remain to be fully elucidated. This narrative review explores the prognostic value and interrelationships of quantitative CAC indicators, as well as their associated risk factors. Traditional CACS, which integrates CAC volume and density, is generally positively correlated with MACE. Nevertheless, its prognostic significance is dual, particularly in the context of statin therapy, where an increase in density-driven scores often indicates plaque stability. High CAC density and its rapid progression serve as protective factors against MACE; however, this protective effect becomes insignificant when CAC volume exceeds 130 mm3. Male sex, smoking, and diabetes tend to promote the progression of CAC volume, whereas female sex, lipoprotein(a), physical activity, and body weight are associated with the progression of CAC density. Notably, CAC assessment has evolved from a single traditional CACS to a comprehensive, multi-parameter evaluation system incorporating such as CACS, CAC density, and volume. Effectively leveraging their interrelationships can help improve the predictive value of CAC."}