Measuring the effect of risk factors on coronary atherosclerosis: Coronary calcium score versus angiographic disease severity

Axel Schmermund, Dietrich Baumgart, Günter Görge, Dietrich Grönemeyer, Rainer Seibel, Kent R Bailey, John A. Rumberger, Dietrich Paar, Raimund Erbel

Research output: Contribution to journalArticle

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Abstract

Objectives. This study sought to determine whether noninvasive quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of cardiovascular risk factors on coronary atherosclerosis. Background. Electron beam computed tomography (EBCT) allows the delineation of anatomic coronary atherosclerotic disease and may be useful for noninvasively defining the role of established and new cardiovascular risk factors in selected patient groups. Methods. A total of 211 consecutive patients, 26 to 79 years old, referred for evaluation of suspected or recently diagnosed coronary artery disease were examined. Selective coronary angiography was used to define five angiographic disease categories: normal coronary arteries, nonobstructive disease and one-, two or three-vessel disease. EBCT was used to calculate coronary calcium scores, and cardiovascular risk, including lipid variables and fibrinogen levels, was assessed. Results. Coronary calcium score and angiographic disease severity categories were largely predicted by identical risk factors (i.e., age, male gender, total/high density lipoprotein cholesterol ratio, fibrinogen) and, to a lesser degree, hypertension. Only smoking predicted angiographic disease severity but not calcium scores. The risk factors together explained a comparable proportion of the variability in angiographic disease categories and in calcium score quintiles (33% vs. 41%, p = 0.16 by bootstrap analysis). An overall risk score composed of these risk factors separated angiographic disease categories and calcium score quintiles with a similar area under the receiver operating characteristic curve ([mean ± SE] 0.81 ± 0.03 vs. 0.83 ± 0.03, p = NS). Conclusions. Quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of established cardiovascular risk factors on coronary atherosclerosis. Thus, EBCT may be useful for the noninvasive evaluation of the relations between conventional or developing cardiovascular risk factors and coronary atherosclerosis.

Original languageEnglish (US)
Pages (from-to)1267-1273
Number of pages7
JournalJournal of the American College of Cardiology
Volume31
Issue number6
DOIs
StatePublished - May 1998

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Coronary Artery Disease
Calcium
X Ray Computed Tomography
Coronary Angiography
Fibrinogen
ROC Curve
HDL Cholesterol
Coronary Disease
Smoking
Hypertension
Lipids

ASJC Scopus subject areas

  • Nursing(all)

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Measuring the effect of risk factors on coronary atherosclerosis : Coronary calcium score versus angiographic disease severity. / Schmermund, Axel; Baumgart, Dietrich; Görge, Günter; Grönemeyer, Dietrich; Seibel, Rainer; Bailey, Kent R; Rumberger, John A.; Paar, Dietrich; Erbel, Raimund.

In: Journal of the American College of Cardiology, Vol. 31, No. 6, 05.1998, p. 1267-1273.

Research output: Contribution to journalArticle

Schmermund, Axel ; Baumgart, Dietrich ; Görge, Günter ; Grönemeyer, Dietrich ; Seibel, Rainer ; Bailey, Kent R ; Rumberger, John A. ; Paar, Dietrich ; Erbel, Raimund. / Measuring the effect of risk factors on coronary atherosclerosis : Coronary calcium score versus angiographic disease severity. In: Journal of the American College of Cardiology. 1998 ; Vol. 31, No. 6. pp. 1267-1273.
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abstract = "Objectives. This study sought to determine whether noninvasive quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of cardiovascular risk factors on coronary atherosclerosis. Background. Electron beam computed tomography (EBCT) allows the delineation of anatomic coronary atherosclerotic disease and may be useful for noninvasively defining the role of established and new cardiovascular risk factors in selected patient groups. Methods. A total of 211 consecutive patients, 26 to 79 years old, referred for evaluation of suspected or recently diagnosed coronary artery disease were examined. Selective coronary angiography was used to define five angiographic disease categories: normal coronary arteries, nonobstructive disease and one-, two or three-vessel disease. EBCT was used to calculate coronary calcium scores, and cardiovascular risk, including lipid variables and fibrinogen levels, was assessed. Results. Coronary calcium score and angiographic disease severity categories were largely predicted by identical risk factors (i.e., age, male gender, total/high density lipoprotein cholesterol ratio, fibrinogen) and, to a lesser degree, hypertension. Only smoking predicted angiographic disease severity but not calcium scores. The risk factors together explained a comparable proportion of the variability in angiographic disease categories and in calcium score quintiles (33{\%} vs. 41{\%}, p = 0.16 by bootstrap analysis). An overall risk score composed of these risk factors separated angiographic disease categories and calcium score quintiles with a similar area under the receiver operating characteristic curve ([mean ± SE] 0.81 ± 0.03 vs. 0.83 ± 0.03, p = NS). Conclusions. Quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of established cardiovascular risk factors on coronary atherosclerosis. Thus, EBCT may be useful for the noninvasive evaluation of the relations between conventional or developing cardiovascular risk factors and coronary atherosclerosis.",
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T1 - Measuring the effect of risk factors on coronary atherosclerosis

T2 - Coronary calcium score versus angiographic disease severity

AU - Schmermund, Axel

AU - Baumgart, Dietrich

AU - Görge, Günter

AU - Grönemeyer, Dietrich

AU - Seibel, Rainer

AU - Bailey, Kent R

AU - Rumberger, John A.

AU - Paar, Dietrich

AU - Erbel, Raimund

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N2 - Objectives. This study sought to determine whether noninvasive quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of cardiovascular risk factors on coronary atherosclerosis. Background. Electron beam computed tomography (EBCT) allows the delineation of anatomic coronary atherosclerotic disease and may be useful for noninvasively defining the role of established and new cardiovascular risk factors in selected patient groups. Methods. A total of 211 consecutive patients, 26 to 79 years old, referred for evaluation of suspected or recently diagnosed coronary artery disease were examined. Selective coronary angiography was used to define five angiographic disease categories: normal coronary arteries, nonobstructive disease and one-, two or three-vessel disease. EBCT was used to calculate coronary calcium scores, and cardiovascular risk, including lipid variables and fibrinogen levels, was assessed. Results. Coronary calcium score and angiographic disease severity categories were largely predicted by identical risk factors (i.e., age, male gender, total/high density lipoprotein cholesterol ratio, fibrinogen) and, to a lesser degree, hypertension. Only smoking predicted angiographic disease severity but not calcium scores. The risk factors together explained a comparable proportion of the variability in angiographic disease categories and in calcium score quintiles (33% vs. 41%, p = 0.16 by bootstrap analysis). An overall risk score composed of these risk factors separated angiographic disease categories and calcium score quintiles with a similar area under the receiver operating characteristic curve ([mean ± SE] 0.81 ± 0.03 vs. 0.83 ± 0.03, p = NS). Conclusions. Quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of established cardiovascular risk factors on coronary atherosclerosis. Thus, EBCT may be useful for the noninvasive evaluation of the relations between conventional or developing cardiovascular risk factors and coronary atherosclerosis.

AB - Objectives. This study sought to determine whether noninvasive quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of cardiovascular risk factors on coronary atherosclerosis. Background. Electron beam computed tomography (EBCT) allows the delineation of anatomic coronary atherosclerotic disease and may be useful for noninvasively defining the role of established and new cardiovascular risk factors in selected patient groups. Methods. A total of 211 consecutive patients, 26 to 79 years old, referred for evaluation of suspected or recently diagnosed coronary artery disease were examined. Selective coronary angiography was used to define five angiographic disease categories: normal coronary arteries, nonobstructive disease and one-, two or three-vessel disease. EBCT was used to calculate coronary calcium scores, and cardiovascular risk, including lipid variables and fibrinogen levels, was assessed. Results. Coronary calcium score and angiographic disease severity categories were largely predicted by identical risk factors (i.e., age, male gender, total/high density lipoprotein cholesterol ratio, fibrinogen) and, to a lesser degree, hypertension. Only smoking predicted angiographic disease severity but not calcium scores. The risk factors together explained a comparable proportion of the variability in angiographic disease categories and in calcium score quintiles (33% vs. 41%, p = 0.16 by bootstrap analysis). An overall risk score composed of these risk factors separated angiographic disease categories and calcium score quintiles with a similar area under the receiver operating characteristic curve ([mean ± SE] 0.81 ± 0.03 vs. 0.83 ± 0.03, p = NS). Conclusions. Quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of established cardiovascular risk factors on coronary atherosclerosis. Thus, EBCT may be useful for the noninvasive evaluation of the relations between conventional or developing cardiovascular risk factors and coronary atherosclerosis.

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