Predictive Value of Electron Beam Computed Tomography of the Coronary Arteries 19-Month Follow-up of 1173 Asymptomatic Subjects

• Published in: Circulation (New York, N.Y.) Vol. 93; no. 11; pp. 1951 - 1953
• Main Authors: Arad, Yadon, Spadaro, Louise A., Goodman, Ken, Lledo-Perez, Alfonso, Sherman, Scott, Lerner, Gail, Guerci, Alan D.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.06.1996; American Heart Association, Inc
• Subjects: Angioplasty - statistics & numerical data; Biological and medical sciences; Brain Ischemia - epidemiology; Calcinosis - diagnostic imaging; Calcium - analysis; Cardiovascular system; Coronary Angiography - methods; Coronary Artery Bypass - statistics & numerical data; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Vessels - chemistry; Coronary Vessels - pathology; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - etiology; Disease Progression; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Mass Screening; Medical sciences; Myocardial Infarction - epidemiology; Myocardial Infarction - etiology; Myocardial Infarction - prevention & control; Radiodiagnosis. Nmr imagery. Nmr spectrometry; ROC Curve; Sensitivity and Specificity; Human; Evaluation; Prognosis; Radiodiagnosis; Calcium; Coronary artery; Electron beam; Cardiovascular disease; Coronary heart disease; Vascular disease; Measurement technique; Atherosclerosis; Computerized axial tomography
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.93.11.1951

Background Coronary electron beam computed tomography (EBCT) detects atherosclerotic coronary artery disease by measuring calcium deposition in the walls of coronary arteries. EBCT-derived coronary artery calcium (CAC) scores correlate with the severity of underlying coronary artery disease. Methods and Results We followed 1173 asymptomatic patients who underwent EBCT between September 1993 and March 1994. During average follow-up of 19 months, 18 subjects had 26 cardiovascular events: 1 death, 7 myocardial infarctions, 8 coronary artery bypass graft procedures, 9 coronary angioplasties, and 1 nonhemorrhagic stroke. For CAC score thresholds of 100, 160, and 680, EBCT had sensitivities of 89%, 89%, and 50% and specificities of 77%, 82%, and 95%, respectively. Odds ratios ranged from 20.0 to 35.4 ( P <.00001 for all). Conclusions Coronary EBCT predicts future atherosclerotic cardiovascular disease events in asymptomatic subjects.