|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1999; 34:777-786 © 1999 by the American College of Cardiology Foundation |
* Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA
Department of Diagnostic Radiology, Mayo Clinic and Foundation, Rochester, Minnesota, USA
Section of Biostatistics, Mayo Clinic and Foundation, Rochester, Minnesota; USA
University of Texas–Houston Medical School, Department of Internal Medicine (Cardiology Division), Houston, Texas, USA
Manuscript received August 20, 1998; revised manuscript received April 9, 1999, accepted May 16, 1999.
Reprint requests and correspondence: Dr. Axel Schmermund, Department of Cardiology, University Clinic Essen, Hufelandstrasse 55, D-45122 Essen, Germany
Axel.Schmermund{at}uni-essen.de
OBJECTIVES
The study was done to test the ability to predict the extent of angiographically determined coronary artery disease (CAD) by quantification of coronary calcium using electron-beam computed tomography (EBCT) and to compare it with more conventional parameters for delineating the angiographic extent of CAD, that is, cardiovascular risk factors and radionuclide single-photon emission computed tomography (SPECT).
BACKGROUND
The angiographic extent of CAD is a powerful predictor of subsequent events. Use of EBCT may be able to define it by virtue of its ability to determine plaque burden.
METHODS
We examined 308 patients presenting with suspected but not previously known CAD who underwent selective coronary angiography. As measures of the angiographic extent of CAD, coronary artery greater even 20 (CAGE 
20) and CAGE 50 scores represented the total number of coronary segments with 20% or 50% stenoses, respectively. The EBCT-derived total calcium scores were obtained in 291 patients, risk factors as defined by the National Cholesterol Education Program in 239 patients, and SPECT scans in 136 patients.
RESULTS
Using multiple linear regression analysis, total calcium scores were better independent predictors of both CAGE 20 and CAGE 50 scores than either a SPECT-derived radionuclide perfusion score or the risk factors age, male gender and ratio of total/high-density lipoprotein (HDL) cholesterol. The association between EBCT and angiographic scores remained highly significant after excluding the influence of all interrelated risk factors and SPECT variables (r = 0.65; p < 0.001 for CAGE 20 scores, r = 0.50; p < 0.001 for CAGE 50 scores).
CONCLUSIONS
Coronary calcium predicts the angiographic extent of CAD in symptomatic patients and provides independent and incremental information to the more conventional clinical parameters derived from SPECT or risk assessment.
| ||||||||||||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  G. Tacoy, A. S. Balcioglu, S. Akinci, G. Erdem, S. A. Kocaman, T. Timurkaynak, and A. Cengel Traditional Risk Factors Are Predictive on Segmental Localization of Coronary Artery Disease Angiology, August 1, 2008; 59(4): 402 - 407. [Abstract] [PDF]
|
|
|
|
 |
|
 I. Gottlieb and J. A.C. Lima Screening High-Risk Patients With Computed Tomography Angiography Circulation, March 11, 2008; 117(10): 1318 - 1332. [Full Text] [PDF]
|
|
|
|
 |
|
 A. D. Guerci The Prognostic Accuracy of Coronary Calcification J. Am. Coll. Cardiol., May 8, 2007; 49(18): 1871 - 1873. [Full Text] [PDF]
|
|
|
|
 |
|
 N Sekhri, G S Feder, C Junghans, H Hemingway, and A D Timmis How effective are rapid access chest pain clinics? Prognosis of incident angina and non-cardiac chest pain in 8762 consecutive patients Heart, April 1, 2007; 93(4): 458 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Rozanski, H. Gransar, N. D. Wong, L. J. Shaw, R. Miranda-Peats, D. Polk, S. W. Hayes, J. D. Friedman, and D. S. Berman Clinical Outcomes After Both Coronary Calcium Scanning and Exercise Myocardial Perfusion Scintigraphy J. Am. Coll. Cardiol., March 27, 2007; 49(12): 1352 - 1361. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Greenland, R. O. Bonow, B. H. Brundage, M. J. Budoff, M. J. Eisenberg, S. M. Grundy, M. S. Lauer, W. S. Post, P. Raggi, R. F. Redberg, et al. ACCF/AHA 2007 Clinical Expert Consensus Document on Coronary Artery Calcium Scoring By Computed Tomography in Global Cardiovascular Risk Assessment and in Evaluation of Patients With Chest Pain: A Report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography) Developed in Collaboration With the Society of Atherosclerosis Imaging and Prevention and the Society of Cardiovascular Computed Tomography J. Am. Coll. Cardiol., January 23, 2007; 49(3): 378 - 402. [Full Text] [PDF]
|
|
|
|
|
|
S. J. Nicholls, E. M. Tuzcu, K. Wolski, I. Sipahi, P. Schoenhagen, T. Crowe, S. R. Kapadia, S. L. Hazen, and S. E. Nissen Coronary Artery Calcification and Changes in Atheroma Burden in Response to Established Medical Therapies J. Am. Coll. Cardiol., January 16, 2007; 49(2): 263 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hamon, G. G.L. Biondi-Zoccai, P. Malagutti, P. Agostoni, R. Morello, M. Valgimigli, and M. Hamon Diagnostic Performance of Multislice Spiral Computed Tomography of Coronary Arteries as Compared With Conventional Invasive Coronary Angiography: A Meta-Analysis J. Am. Coll. Cardiol., November 7, 2006; 48(9): 1896 - 1910. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Budoff, S. Achenbach, R. S. Blumenthal, J. J. Carr, J. G. Goldin, P. Greenland, A. D. Guerci, J. A.C. Lima, D. J. Rader, G. D. Rubin, et al. Assessment of Coronary Artery Disease by Cardiac Computed Tomography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology Circulation, October 17, 2006; 114(16): 1761 - 1791. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Wittlinger, I. Martinovic, R. Moosdorf, and A. Moritz Imaging of calcified coronary arteries with multislice computed tomography. Asian Cardiovasc Thorac Ann, August 1, 2006; 14(4): 321 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Berman, R. Hachamovitch, L. J. Shaw, J. D. Friedman, S. W. Hayes, L. E.J. Thomson, D. S. Fieno, G. Germano, P. Slomka, N. D. Wong, et al. Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Assessment of Patients with Suspected Coronary Artery Disease J. Nucl. Med., January 1, 2006; 47(1): 74 - 82. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. S. Berman, N. D. Wong, H. Gransar, R. Miranda-Peats, J. Dahlbeck, S. W. Hayes, J. D. Friedman, X. Kang, D. Polk, R. Hachamovitch, et al. Relationship between stress-induced myocardial ischemia and atherosclerosis measured by coronary calcium tomography J. Am. Coll. Cardiol., August 18, 2004; 44(4): 923 - 930. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Fornage, E. Boerwinkle, P. A. Doris, D. Jacobs, K. Liu, and N. D. Wong Polymorphism of the Soluble Epoxide Hydrolase Is Associated With Coronary Artery Calcification in African-American Subjects: The Coronary Artery Risk Development In Young Adults (CARDIA) Study Circulation, January 27, 2004; 109(3): 335 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Zhu, R. J. Katz, A. A. Quyyumi, D. A. Canos, D. Rott, G. Csako, A. Zalles-Ganley, J. Ogunmakinwa, A. G. Wasserman, and S. E. Epstein Association of Serum Antibodies to Heat-Shock Protein 65 With Coronary Calcification Levels: Suggestion of Pathogen-Triggered Autoimmunity in Early Atherosclerosis Circulation, January 6, 2004; 109(1): 36 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Asanuma, A. Oeser, A. K. Shintani, E. Turner, N. Olsen, S. Fazio, M. F. Linton, P. Raggi, and C. M. Stein Premature Coronary-Artery Atherosclerosis in Systemic Lupus Erythematosus N. Engl. J. Med., December 18, 2003; 349(25): 2407 - 2415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Schaar, C. L. de Korte, F. Mastik, C. Strijder, G. Pasterkamp, E. Boersma, P. W. Serruys, and A. F.W. van der Steen Characterizing Vulnerable Plaque Features With Intravascular Elastography Circulation, November 25, 2003; 108(21): 2636 - 2641. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Takahashi and K. T. Bae Quantification of Coronary Artery Calcium with Multi-Detector row CT: Assessing Interscan Variability with Different Tube Currents—Pilot Study Radiology, July 1, 2003; 228(1): 101 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Shemesh, S. Apter, Y. Itzchak, and M. Motro Coronary Calcification Compared in Patients with Acute versus in Those with Chronic Coronary Events by Using Dual-Sector Spiral CT Radiology, February 1, 2003; 226(2): 483 - 488. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Hunold, F. M. Vogt, A. Schmermund, J. F. Debatin, G. Kerkhoff, T. Budde, R. Erbel, K. Ewen, and J. Barkhausen Radiation Exposure during Cardiac CT: Effective Doses at Multi-Detector Row CT and Electron-Beam CT Radiology, January 1, 2003; 226(1): 145 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Wayhs, A. Zelinger, and P. Raggi High coronary artery calcium scores pose an extremely elevated risk for hard events J. Am. Coll. Cardiol., January 16, 2002; 39(2): 225 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ling Electron Beam CT in Syndrome X Chest, November 1, 2001; 120(5): 1437 - 1439. [Full Text] [PDF]
|
|
|
|
|
|
A. Schmermund and R. Erbel Unstable Coronary Plaque and Its Relation to Coronary Calcium Circulation, October 2, 2001; 104(14): 1682 - 1687. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Beckman, J. Ganz, M. A. Creager, P. Ganz, and S. Kinlay Relationship of Clinical Presentation and Calcification of Culprit Coronary Artery Stenoses Arterioscler. Thromb. Vasc. Biol., October 1, 2001; 21(10): 1618 - 1622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. S. Hecht and H. R. Superko Electron beam tomography and national cholesterol education program guidelines in asymptomatic women J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1506 - 1511. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Huang, R. Virmani, H. Younis, A. P. Burke, R. D. Kamm, and R. T. Lee The Impact of Calcification on the Biomechanical Stability of Atherosclerotic Plaques Circulation, February 27, 2001; 103(8): 1051 - 1056. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Schmermund, D Baumgart, S Sack, S Mohlenkamp, D Gronemeyer, R Seibel, and R Erbel Assessment of coronary calcification by electron-beam computed tomography in symptomatic patients with normal, abnormal or equivocal exercise stress test Eur. Heart J., October 2, 2000; 21(20): 1674 - 1682. [Abstract] [PDF]
|
|
|
|
 |
|
 Coronary Artery Calcium Independently Predicts Extent of CAD Journal Watch Cardiology, October 8, 1999; 1999(1008): 4 - 4. [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
