Circulation. 2003;107:2571-2576
Published online before print May 12, 2003, doi: 10.1161/01.CIR.0000068341.61180.55
Published online before print May 12, 2003, doi: 10.1161/01.CIR.0000068341.61180.55
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(Circulation. 2003;107:2571.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Electron-Beam Tomography Coronary Artery Calcium and Cardiac Events
A 37-Month Follow-Up of 5635 Initially Asymptomatic Low- to Intermediate-Risk Adults
From the Section of Cardiology, Department of Medicine, University of Illinois at Chicago College of Medicine (G.T.K., J.A.H., A.S., S.S.D., E.V.C.); the Department of Medical Surgical Nursing, University of Illinois at Chicago College of Nursing (J.A.F.); and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine (M.L.D., D.B.G., K.L.), Chicago, IL.
Correspondence to George T. Kondos, MD, Section of Cardiology, Department of Medicine (MC 715), UIC College of Medicine, 840 S Wood St, Chicago, IL 60612. E-mail gtkondos{at}uic.edu
Background— Conventional coronary artery disease (CAD) risk factors fail to explain nearly 50% of CAD events. This study examines the association between electron-beam tomography (EBT) coronary artery calcium (CAC) and cardiac events in initially asymptomatic low- to intermediate-risk individuals, with adjustment for the presence of hypercholesterolemia, hypertension, diabetes, and a history of cigarette smoking.
Methods and Results— The study was performed in 8855 initially asymptomatic adults 30 to 76 years old (26% women) who self-referred for EBT CAC screening. Conventional CAD risk factors were elicited by use of a questionnaire. After 37±12 months, information on the occurrence of cardiac events was collected and confirmed by use of medical records and death certificates. In men, events (n=192) were associated with the presence of CAC (RR=10.5, P<0.001), diabetes (RR=1.98, P=0.008), and smoking (RR=1.4, P=0.025), whereas in women, events (n=32) were linked to the presence of CAC (RR=2.6, P=0.037) and not risk factors. The presence of CAC provided incremental prognostic information in addition to age and other risk factors.
Conclusions— The association between EBT CAC and cardiac events observed in this study of initially asymptomatic, middle-aged, low to intermediate-risk individuals presenting for screening suggests that in this group, knowledge of the presence of EBT CAC provides incremental information in addition to that defined by conventional CAD risk assessment.
Key Words: coronary disease • calcium • follow-up studies • risk factors • sex
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M. J. Budoff, M. C. Cohen, M. J. Garcia, J. McB. Hodgson, W. G. Hundley, J. A.C. Lima, W. J. Manning, G. M. Pohost, P. M. Raggi, G. P. Rodgers, et al. ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance: A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training J. Am. Coll. Cardiol., July 19, 2005; 46(2): 383 - 402. [Full Text] [PDF]
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Y. Arad, K. J. Goodman, M. Roth, D. Newstein, and A. D. Guerci Coronary Calcification, Coronary Disease Risk Factors, C-Reactive Protein, and Atherosclerotic Cardiovascular Disease Events: The St. Francis Heart Study J. Am. Coll. Cardiol., July 5, 2005; 46(1): 158 - 165. [Abstract] [Full Text] [PDF]
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P. Raggi, B. Cooil, C. Ratti, T. Q. Callister, and M. Budoff Progression of Coronary Artery Calcium and Occurrence of Myocardial Infarction in Patients With and Without Diabetes Mellitus Hypertension, July 1, 2005; 46(1): 238 - 243. [Abstract] [Full Text] [PDF]
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N. D. Wong, A. Rozanski, H. Gransar, R. Miranda-Peats, X. Kang, S. Hayes, L. Shaw, J. Friedman, D. Polk, and D. S. Berman Metabolic Syndrome and Diabetes Are Associated With an Increased Likelihood of Inducible Myocardial Ischemia Among Patients With Subclinical Atherosclerosis Diabetes Care, June 1, 2005; 28(6): 1445 - 1450. [Abstract] [Full Text] [PDF]
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J. C. Nelson, R. A. Kronmal, J. J. Carr, M. F. McNitt-Gray, N. D. Wong, C. M. Loria, J. G. Goldin, O. D. Williams, and R. Detrano Measuring Coronary Calcium on CT Images Adjusted for Attenuation Differences Radiology, May 1, 2005; 235(2): 403 - 414. [Abstract] [Full Text] [PDF]
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D. E. Bild, R. Detrano, D. Peterson, A. Guerci, K. Liu, E. Shahar, P. Ouyang, S. Jackson, and M. F. Saad Ethnic Differences in Coronary Calcification: The Multi-Ethnic Study of Atherosclerosis (MESA) Circulation, March 15, 2005; 111(10): 1313 - 1320. [Abstract] [Full Text] [PDF]
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M. P. Reilly, M. Lehrke, M. L. Wolfe, A. Rohatgi, M. A. Lazar, and D. J. Rader Resistin Is an Inflammatory Marker of Atherosclerosis in Humans Circulation, February 22, 2005; 111(7): 932 - 939. [Abstract] [Full Text] [PDF]
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D. M. Maahs, L. G. Ogden, G. L. Kinney, P. Wadwa, J. K. Snell-Bergeon, D. Dabelea, J. E. Hokanson, J. Ehrlich, R. H. Eckel, and M. Rewers Low Plasma Adiponectin Levels Predict Progression of Coronary Artery Calcification Circulation, February 15, 2005; 111(6): 747 - 753. [Abstract] [Full Text] [PDF]
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J. H. Mieres, L. J. Shaw, A. Arai, M. J. Budoff, S. D. Flamm, W. G. Hundley, T. H. Marwick, L. Mosca, A. R. Patel, M. A. Quinones, et al. Role of Noninvasive Testing in the Clinical Evaluation of Women With Suspected Coronary Artery Disease: Consensus Statement From the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association Circulation, February 8, 2005; 111(5): 682 - 696. [Abstract] [Full Text] [PDF]
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C. Iribarren, M. D. Gross, J. A. Darbinian, D. R. Jacobs Jr, S. Sidney, and C. M. Loria Association of Lipoprotein-Associated Phospholipase A2 Mass and Activity With Calcified Coronary Plaque in Young Adults: The CARDIA Study Arterioscler Thromb Vasc Biol, January 1, 2005; 25(1): 216 - 221. [Abstract] [Full Text] [PDF]
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J. W. Fischer, S. A. Steitz, P. Y. Johnson, A. Burke, F. Kolodgie, R. Virmani, C. Giachelli, and T. N. Wight Decorin Promotes Aortic Smooth Muscle Cell Calcification and Colocalizes to Calcified Regions in Human Atherosclerotic Lesions Arterioscler Thromb Vasc Biol, December 1, 2004; 24(12): 2391 - 2396. [Abstract] [Full Text] [PDF]
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R. J. Gibbons and P. A. Araoz The year in cardiac imaging J. Am. Coll. Cardiol., November 16, 2004; 44(10): 1937 - 1944. [Full Text] [PDF]
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M. R. G. Araneta and E. Barrett-Connor Subclinical Coronary Atherosclerosis in Asymptomatic Filipino and White Women Circulation, November 2, 2004; 110(18): 2817 - 2823. [Abstract] [Full Text] [PDF]
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K. Nasir, E. D. Michos, J. A. Rumberger, J. B. Braunstein, W. S. Post, M. J. Budoff, and R. S. Blumenthal Coronary Artery Calcification and Family History of Premature Coronary Heart Disease: Sibling History Is More Strongly Associated Than Parental History Circulation, October 12, 2004; 110(15): 2150 - 2156. [Abstract] [Full Text] [PDF]
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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]
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