Score calcique coronarien chez les diabétiques

Coronary artery calcification (CAC) score is measured by computed tomography. CAC score was clearly shown to predict cardiovascular events in the general population and specifically in the diabetic population. The prognostic value of CAC score is additional to the estimation based on usual risk factors. Measuring CAC score seems interesting particularly when the a priori risk is considered as intermediate or high as a score >300 or >400 Agatston units (AU) may reclassify the patients in very high risk. Moreover there is a relation between a high CAC score and a greater prevalence of silent myocardial ischemia (SMI) as detected by stress myocardial perfusion scintigraphy. A score <100 AU provides a fairly good negative predictive value for the absence of SMI. A very high risk score should lead to reinforce preventive treatments and also to screen the patient for SMI. Thus, CAC score measurement contributes to better identify the diabetic patients who should be screened for SMI and to increase the yield of screening.