(Circulation. 1995;91:1363-1367.)
© 1995 American Heart Association, Inc.
Articles |
Coronary Calcium, as Determined by Electron Beam Computed Tomography, and Coronary Disease on Arteriogram
Effect of Patient's Sex on Diagnosis
From the Departments of Cardiovascular Diseases, Internal Medicine (J.A.R., R.S.S.), and Diagnostic Radiology (P.F.S. III, J.F.B.), Mayo Clinic and Foundation, Rochester, Minn.
Correspondence to John A. Rumberger, PhD, MD, Department of Cardiovascular Diseases, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905.
Background Coronary artery calcium identified by electron beam computed tomography (EBCT) has potential for noninvasive localization of coronary atherosclerotic disease. However, the effect of a patient's sex on its diagnostic capability has not been examined in a clinical population.
Methods and Results Fifty women and 89 men had EBCT scans done an
average of 1 day after coronary arteriography. Maximum arteriographic
percent luminal diameter stenosis of any artery was paired with the
total EBCT coronary calcium score for each subject. The women (age,
56±11 years [mean±SD]) were older than the men (age,
47±7 years),
but the subjects were matched for indications for arteriography and
extent of disease as assessed by arteriography. Sensitivity,
specificity, and positive and negative predictive values for coronary
calcium were nearly identical for men and women, regardless of the
degree of arteriographic disease. EBCT was highly sensitive to the
presence of arteriographic disease (range, 94% to 100%), but had only
moderate specificity (57% to 66%) for significant disease (
50%
stenosis) and low specificity (35% to 38%) for any arteriographic
disease (>0% stenosis). Negative predictive values in men and women
ranged from 79% to 91% for any arteriographic disease and from 95%
to 100% for significant disease, respectively. Numerical calcium
scores were significantly different between subjects with normal
arteriograms and those with significant disease; however, calcium score
had limited power to separate trivial, moderate, and significant
disease. Receiver operating characteristic curve areas, determined as
an extension of the analyses of sensitivity and specificity, were high
for EBCT-defined calcium scores for both any arteriographic disease and
significant arteriographic disease, and were not different between the
sexes.
Conclusions In a middle-aged population, noninvasive definition of coronary calcium by EBCT has similar predictive value for arteriographic coronary artery disease in men and women.
Key Words: tomography • coronary disease • patients • angiography • diagnosis • imaging • calcium
This article has been cited by other articles:
 |
|
 |
|
  B. D. Rosen, V. Fernandes, R. L. McClelland, J. J. Carr, R. Detrano, D. A. Bluemke, and J. A.C. Lima Relationship Between Baseline Coronary Calcium Score and Demonstration of Coronary Artery Stenoses During Follow-Up: MESA (Multi-Ethnic Study of Atherosclerosis) J. Am. Coll. Cardiol. Img., October 1, 2009; 2(10): 1175 - 1183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sarwar, L. J. Shaw, M. D. Shapiro, R. Blankstein, U. Hoffman, R. C. Cury, S. Abbara, T. J. Brady, M. J. Budoff, R. S. Blumenthal, et al. Diagnostic and Prognostic Value of Absence of Coronary Artery Calcification J. Am. Coll. Cardiol. Img., June 1, 2009; 2(6): 675 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Kelly, D. Thickman, S. D. Abramson, P. R. Chen, S. F. Smazal, M. J. Fleishman, and S. C. Lingam Coronary CT Angiography Findings in Patients Without Coronary Calcification Am. J. Roentgenol., July 1, 2008; 191(1): 50 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. D. Brook, R. L. Bard, S. Patel, M. Rubenfire, N. S. Clarke, E. A. Kazerooni, T. W. Wakefield, P. K. Henke, and K. A. Eagle A Negative Carotid Plaque Area Test Is Superior to Other Noninvasive Atherosclerosis Studies for Reducing the Likelihood of Having Underlying Significant Coronary Artery Disease Arterioscler Thromb Vasc Biol, March 1, 2006; 26(3): 656 - 662. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Messika-Zeitoun, M.-C. Aubry, D. Detaint, L. F. Bielak, P. A. Peyser, P. F. Sheedy, S. T. Turner, J. F. Breen, C. Scott, A. J. Tajik, et al. Evaluation and Clinical Implications of Aortic Valve Calcification Measured by Electron-Beam Computed Tomography Circulation, July 20, 2004; 110(3): 356 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Asanuma, A. Oeser, A. K. Shintani, E. Turner, N. Olsen, S. Fazio, M. F. Linton, P. Raggi, and C. M. Stein Premature Coronary-Artery Atherosclerosis in Systemic Lupus Erythematosus N. Engl. J. Med., December 18, 2003; 349(25): 2407 - 2415. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Watanabe, T. Hiroki, and N. Koga Relation of Thoracic Aorta Calcification on Computed Tomography and Coronary Risk Factors to Obstructive Coronary Artery Disease on Angiography Angiology, July 1, 2003; 54(4): 433 - 441. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Erbell, T. Budde, G. Kerkhoff, S. Mohlenkamp, and A. Schmermund Understanding the pathophysiology of the arterial wall: which method should we choose? Electron beam computed tomography Eur. Heart J. Suppl., September 1, 2002; 4(suppl_F): F47 - F53. [Abstract] [PDF]
|
|
|
|
 |
|
 J. A. Coladonato, L. A. Szczech, E. A. Friedman, and W. F. Owen Jr Does calcium kill ESRD patients--the skeptic's perspective Nephrol. Dial. Transplant., February 1, 2002; 17(2): 229 - 232. [Full Text] [PDF]
|
|
|
|
 |
|
 B. K. Nallamothu, S. Saint, L. F. Bielak, S. S. Sonnad, P. A. Peyser, M. Rubenfire, and A. M. Fendrick Electron-Beam Computed Tomography in the Diagnosis of Coronary Artery Disease: A Meta-analysis Arch Intern Med, March 26, 2001; 161(6): 833 - 838. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Haberl, A. Becker, A. Leber, A. Knez, C. Becker, C. Lang, R. Bruning, M. Reiser, and G. Steinbeck Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: results of 1,764 patients J. Am. Coll. Cardiol., February 1, 2001; 37(2): 451 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Farzaneh-Far Electron beam computed tomography: on its way into mainstream cardiology? Eur. Heart J., September 2, 2000; 21(18): 1556 - 1557. [PDF]
|
|
|
|
|
|
L. F. Bielak, J. A. Rumberger, P. F. Sheedy II, R. S. Schwartz, and P. A. Peyser Probabilistic Model for Prediction of Angiographically Defined Obstructive Coronary Artery Disease Using Electron Beam Computed Tomography Calcium Score Strata Circulation, July 25, 2000; 102(4): 380 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. O'Rourke, B. H. Brundage, V. F. Froelicher, P. Greenland, S. M. Grundy, R. Hachamovitch, G. M. Pohost, L. J. Shaw, W. S. Weintraub, W. L. Winters Jr, et al. American College of Cardiology/American Heart Association Expert Consensus Document on Electron-Beam Computed Tomography for the Diagnosis and Prognosis of Coronary Artery Disease : Committee Members Circulation, July 4, 2000; 102(1): 126 - 140. [Full Text] [PDF]
|
|
|
|
|
|
D. M. Shavelle, M. J. Budoff, D. H. LaMont, R. M. Shavelle, J. M. Kennedy, and B. H. Brundage Exercise testing and electron beam computed tomography in the evaluation of coronary artery disease J. Am. Coll. Cardiol., July 1, 2000; 36(1): 32 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. O'Rourke, B. H. Brundage, V. F. Froelicher, P. Greenland, S. M. Grundy, R. Hachamovitch, G. M. Pohost, L. J. Shaw, W. S. Weintraub, W. L. Winters Jr, et al. American College of Cardiology/American Heart Association expert consensus document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease J. Am. Coll. Cardiol., July 1, 2000; 36(1): 326 - 340. [Full Text] [PDF]
|
|
|
|
|
|
W. G. Goodman, J. Goldin, B. D. Kuizon, C. Yoon, B. Gales, D. Sider, Y. Wang, J. Chung, A. Emerick, L. Greaser, et al. Coronary-Artery Calcification in Young Adults with End-Stage Renal Disease Who Are Undergoing Dialysis N. Engl. J. Med., May 18, 2000; 342(20): 1478 - 1483. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Erbel, A Schmermund, S Mohlenkamp, S Sack, and D Baumgart Electron-beam computed tomography for detection of early signs of coronary arteriosclerosis Eur. Heart J., May 1, 2000; 21(9): 720 - 732. [PDF]
|
|
|
|
 |
|
 B. W. K. Kwok, Y. T. Lim, S. T. Quek, L. K. A. Tan, B. Kwok Wing Kuin, Y. T. Lim, S. T. Quek, and L. Tan Kheng Ann Electron-Beam Computed Tomography for Symptomatic Coronary Disease Asian Cardiovasc Thorac Ann, March 1, 2000; 8(1): 46 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Nishino, M. J. Malloy, J. Naya-Vigne, J. Russell, J. P. Kane, and R. F. Redberg Lack of association of lipoprotein(a) levels with coronary calcium deposits in asymptomatic postmenopausal women J. Am. Coll. Cardiol., February 1, 2000; 35(2): 314 - 320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Sechtem Electron beam computed tomography: on its way into mainstrem cardiology? Eur. Heart J., January 2, 2000; 21(2): 87 - 91. [PDF]
|
|
|
|
|
|
A. Schmermund, A. E. Denktas, J. A. Rumberger, T. F. Christian, P. F. Sheedy II, K. R. Bailey, and R. S. Schwartz Independent and incremental value of coronary artery calcium for predicting the extent of angiographic coronary artery disease: Comparison with cardiac risk factors and radionuclide perfusion imaging J. Am. Coll. Cardiol., September 1, 1999; 34(3): 777 - 786. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M R Bell, L O Lerman, and J A Rumberger Validation of minimally invasive measurement of myocardial perfusion using electron beam computed tomography and application in human volunteers Heart, June 1, 1999; 81(6): 628 - 635. [Abstract] [Full Text]
|
|
|
|
|
|
A. Schmermund, K. R. Bailey, J. A. Rumberger, J. E. Reed, P. F. Sheedy II, and R. S. Schwartz An algorithm for noninvasive identification of angiographic three-vessel and/or left main coronary artery disease in symptomatic patients on the basis of cardiac risk and electron-beam computed tomographic calcium scores J. Am. Coll. Cardiol., February 1, 1999; 33(2): 444 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Rumberger, T. Behrenbeck, J. F. Breen, and P. F. Sheedy II Coronary calcification by electron beam computed tomography and obstructive coronary artery disease: a model for costs and effectiveness of diagnosis as compared with conventional cardiac testing methods J. Am. Coll. Cardiol., February 1, 1999; 33(2): 453 - 462. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Gidding, L. C. Bookstein, and E. V. Chomka Usefulness of Electron Beam Tomography in Adolescents and Young Adults With Heterozygous Familial Hypercholesterolemia Circulation, December 8, 1998; 98(23): 2580 - 2583. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Guerci, L. A. Spadaro, K. J. Goodman, A. Lledo-Perez, D. Newstein, G. Lerner, and Y. Arad Comparison of electron beam computed tomography scanning and conventional risk factor assessment for the prediction of angiographic coronary artery disease J. Am. Coll. Cardiol., September 1, 1998; 32(3): 673 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Stanford and B. H. Thompson Coronary atherosclerosis and its effect on cardiac structure and function: evaluation by electron beam computed tomography Clin. Chem., August 1, 1998; 44(8): 1871 - 1881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Watson, M. L. Abrolat, L. L. Malone, J. M. Hoeg, T. Doherty, R. Detrano, and L. L. Demer Active Serum Vitamin D Levels Are Inversely Correlated With Coronary Calcification Circulation, September 16, 1997; 96(6): 1755 - 1760. [Abstract] [Full Text]
|
|
|
|
|
|
A. Schmermund, D. Baumgart, G. Gorge, R. Seibel, D. Gronemeyer, J. Ge, M. Haude, J. Rumberger, and R. Erbel Coronary Artery Calcium in Acute Coronary Syndromes : A Comparative Study of Electron-Beam Computed Tomography, Coronary Angiography, and Intracoronary Ultrasound in Survivors of Acute Myocardial Infarction and Unstable Angina Circulation, September 2, 1997; 96(5): 1461 - 1469. [Abstract] [Full Text]
|
|
|
|
|
|
L. Wexler, B. Brundage, J. Crouse, R. Detrano, V. Fuster, J. Maddahi, J. Rumberger, W. Stanford, R. White, and K. Taubert Coronary Artery Calcification: Pathophysiology, Epidemiology, Imaging Methods, and Clinical Implications: A Statement for Health Professionals From the American Heart Association Circulation, September 1, 1996; 94(5): 1175 - 1192. [Full Text]
|
|
|
|
|
|
A. Halkin, D. Leibowitz, R. H. Hunn, C. I. Stroh, J. Shemesh, M. Motro, N. A. Hirani, J. L. Kaufman, W. J. Donnelly, M. Sirmon, et al. Management of Acute Mesenteric Ischemia N. Engl. J. Med., August 22, 1996; 335(8): 594 - 596. [Full Text]
|
|
|
|
|
|
J. A. Rumberger, D. B. Simons, L. A. Fitzpatrick, P. F. Sheedy, and R. S. Schwartz Coronary Artery Calcium Area by Electron-Beam Computed Tomography and Coronary Atherosclerotic Plaque Area : A Histopathologic Correlative Study Circulation, October 15, 1995; 92(8): 2157 - 2162. [Abstract] [Full Text]
|
|