TY - JOUR
T1 - Independent and incremental value of coronary artery calcium for predicting the extent of angiographic coronary artery disease
T2 - Comparison with cardiac risk factors and radionuclide perfusion imaging
AU - Schmermund, Axel
AU - Denktas, Ali E.
AU - Rumberger, John A.
AU - Christian, Timothy F.
AU - Sheedy, Patrick F.
AU - Bailey, Kent R.
AU - Schwartz, Robert S.
N1 - Funding Information:
This study was funded by the Mayo Foundation, Rochester, Minnesota. Dr. Schmermund was supported by a Heart Center Cardiovascular Research Grant (Schm 97-1) from the University Clinic Essen, Germany.
PY - 1999/9
Y1 - 1999/9
N2 - 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.
AB - 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.
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U2 - 10.1016/S0735-1097(99)00265-X
DO - 10.1016/S0735-1097(99)00265-X
M3 - Article
C2 - 10483960
AN - SCOPUS:0032835123
SN - 0735-1097
VL - 34
SP - 777
EP - 786
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 3
ER -