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 Coronary Calcification.
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).
Recent refinement of calcium scoring has been introduced to harness further information related to coronary plaque. This lesion-specific calcium-scoring method has been shown to be superior to the Agatston Score.
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