Agatston score

In diagnostic cardiology, the Agatston score, named after its developer Arthur Agatston, is a measure of calcium generally included in the results from a CT Test for calcification of the coronary arteries.[1]

The Agatston score is derived from the work of Drs. Agatston and Janowitz of the University of Miami School of Medicine and dates back into the 1980s. The original work was based on electron beam computed tomography (also known as ultrafast CT or EBCT). The score is calculated using a weighted value assigned to the highest density of calcification in a given coronary artery. The density is measured in Hounsfield units, and score of 1 for 130–199 HU, 2 for 200–299 HU, 3 for 300–399 HU, and 4 for 400 HU and greater. This weighted score is then multiplied by the area (in square millimeters) of the coronary calcification. For example, a "speck" of coronary calcification in the left anterior descending artery measures 4 square millimeters and has a peak density of 270 HU. The score is therefore 8 (4 square millimeters × weighted score of 2). The tomographic slices of the heart are 3 millimeters thick and average about 50–60 slices from the coronary artery ostia to the inferior wall of the heart. The calcium score of every calcification in each coronary artery for all of the tomographic slices is then summed up to give the total coronary artery calcium score (CAC score).

Several variations of the Agatston score have been described, including mass-based calcium scoring, volume-based calcium scoring, or lesion-specific calcium-scoring, described in a 2010 paper by Szilard Voros and his team.[2] These alternative methods have various advantages, including improved reproducibility or superior diagnostic outcomes in preliminary studies. Some of these methods are grounded on particular insights into the disease process. For example, it has been argued that increased calcification of plaque is protective against rupture, and therefore, a higher weighting for denser calcifications is counterproductive. Despite incremental improvements for alternative scoring methods, the Agatston score remains the most commonly practiced calcium scoring method today because of the number of studies and the strength of the data used for its validation.

See also

References

  1. ↑ Hoffmann U, Brady TJ, Muller J (August 2003). "Cardiology patient page. Use of new imaging techniques to screen for coronary artery disease". Circulation. 108 (8): e50–3. PMID 12939244. doi:10.1161/01.CIR.0000085363.88377.F2.
  2. ↑ Qian Z, Anderson H, Marvasty I, et al. (2010). "Lesion- and vessel-specific coronary artery calcium scores are superior to whole-heart Agatston and volume scores in the diagnosis of obstructive coronary artery disease". J Cardiovasc Comput Tomogr. 4 (6): 391–9. PMID 21035423. doi:10.1016/j.jcct.2010.09.001.
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