Stratification of Cardiovascular Risk By Cardiac Computerized Tomography - Shall We Keep on Ignoring?

Abstract

6. Rochitte CE, Pinto IM, Fernandes JL, Filho CF, Jatene A, Carvalho AC, et al; Grupo de Estudos de Ressonância e Tomografia Cardiovascular (GERT) do Departamento de Cardiologia Clinica da Sociedade Brasileira de Cardiologia, [I cardiovascular magnetic resonance and computed tomography guidelines of the Brazilian Society of Cardiologia Executive summary]. Arq Bras Cardiol. 2006;87(3):e48-59. References DOI: 10.5935/abc.20130096 In Volume 98, Issue 6, June 2012, we read with great interest the article written by Azevedo et al1, in which the role of calcium scoring and coronary CT angiography in cardiovascular risk stratification was extensively discussed. The issue deserves thorough scientific discussion and the transition to everyday clinical practice should be rethought. Although the intention has been to conduct a review based on scientific evidence in the literature, which often makes reference to populations not comparable to ours, it was observed that many of the studies used as scientific evidence represent a large portion of the Brazilian population. Examples of such are the works of Monteiro et al2, Rosario et al3 and Azevedo et al4, in addition to the important CORE 645, in which Brazil was the country that included the most patients. We believe that the scientific base was very well prepared, but it lacked in discussing the transition to clinical practice. This is extremely important in line with the authors’ experience, mainly due to the lack of Brazilian guideline updates, which are dated from 20066. In the last six years, clinical practice highlights the significant increase in the use of cardiac computed tomography (CCT), given that some services already use this method as a first option in cardiovascular risk stratification by noninvasive imaging.