Relation of Coronary Calcium Score by Electron Beam Computed Tomography to Arteriographic Findings in Asymptomatic and Symptomatic Adults
Section snippets
Patient Selection
We reasoned that the results of regression trials, which indicate substantial benefit of vigorous cholesterol lowering treatments,1, 2 would be sufficiently applicable to patients with elevated calcium scores to justify the risks of coronary arteriography. Therefore, with the approval of the St. Francis Hospital Institutional Review Board (IRB) and the subjects' personal physicians, we invited men and women <70 years of age, who had previously undergone electron beam tomography of the heart, to
Asymptomatic Patients
Of the 256 asymptomatic persons with elevated coronary calcium scores invited to participate in the study, 18 agreed. Mean age and calcium score (± 1 SD) were 55 ± 7 years and 573 ± 504 units for the 18 asymptomatic subjects with elevated calcium scores versus 58 ± 8 years and 471 ± 546 units for the 238 who declined (p = NS for both). The number and distribution of nonlipid risk factors[14] was similar in the 18 asymptomatic subjects who agreed to participate and those who refused (Table 1).
Discussion
Four studies of electron beam tomography in >1,200 symptomatic patients undergoing cardiac catheterization have reported significant differences in calcium scores for patients with normal coronary arteries, nonobstructive coronary disease, and obstructive coronary disease.12, 15, 16, 17 However, the use of these data in the interpretation of coronary calcium scores in asymptomatic adults has been challenged because the prevalence of each of the 3 disease states in the general population is
Acknowledgements
This study was supported by a grant from the St. Francis Hospital Foundation, Roslyn, New York.
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2018, Journal of Vascular SurgeryCitation Excerpt :In the coronary arteries, where calcium scoring has long been used to predict occlusive disease, Rumberger et al35 found a correlation coefficient between calcium and occlusive lesions of 0.9 when examined on pathologic samples. In clinical studies involving the coronary arteries, the correlation between angiographic occlusion and calcium score was also found to be significant; however to a lesser degree in symptomatic patients (symptomatic R = 0.51; asymptomatic R = 0.85).36 In the lower extremities, this association has not been reported previously.
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