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(Circulation. 2008;117:1318-1332.)
© 2008 American Heart Association, Inc.

Controversies in Cardiovascular Medicine

Should all high-risk patients be screened with computed tomography angiography?

Screening High-Risk Patients With Computed Tomography Angiography

Ilan Gottlieb, MD; João A.C. Lima, MD

From the Johns Hopkins Hospital, Baltimore, Md (I.G., J.A.C.L.) and Federal University of Rio de Janeiro, Cardiology Department, Medicine, Rio de Janeiro, Brazil (I.G.).

Correspondence to Joao Lima, MD, Johns Hopkins Hospital, 600 N Wolfe St, Blalock 524, Baltimore, MD 21287. E-mail jlima@jhmi.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Earlier this year, among the usual menu of worrisome daily news, Americans woke up to learn that for the first time in the nation’s history, annual mortality caused by cancer had declined significantly.¹ Cancer experts told us in addition that such decline resulted mainly from a reduction in smoking among American men but also as a consequence of successful screening programs for breast and colon cancers, 2 of the most important killers in industrialized countries.² The American Cancer Society, American Heart Association, and American Diabetes Association have proposed joint efforts to prevent and foster the early detection of cardiovascular diseases, cancer, and diabetes.³ Specifically, the American Cancer Society recommends screening for breast cancer starting at age 20 years with annual mammography starting at age 40, screening for cervical cancer to begin at age 21, and screening for colon and prostate cancer to begin at age 50.

	Screening Asymptomatic Individuals at Risk for Coronary Artery Disease Events: An Unmet Need

 
The approach to prevent cardiovascular diseases has, on the one hand, focused primarily on the control of new traditional risk factors and biomarkers identified at first by the Framingham study but since then characterized and refined by a multitude of other large prospective studies, clinical trials, and consensus panels involving scientists, physicians, educators, and other healthcare professionals all over the world.^4,5 The latter effort has paid enormous dividends and is considered to be responsible in large part for the declining cardiovascular disease mortality seen in the United States.⁶

Response by Kramer p 1332

However, much too often, we learn of someone who died suddenly . . . [Full Text of this Article]