Document Detail

Coronary calcification score: the coronary-risk impact factor.
MedLine Citation:
PMID:  14976978     Owner:  NLM     Status:  MEDLINE    
CONTEXT: Identification of asymptomatic high-risk individuals is integral to current policies for preventing coronary heart disease, but existing methods of estimating risk lack sensitivity. To overcome this limitation increasing use is being made of non-invasive methods to detect subclinical coronary artery disease--eg, computed tomography (CT) to scan for coronary artery calcification. The location and extent of calcification correlate closely with pathological and angiographic abnormalities, but whether such calcification predicts clinical events, especially in younger individuals, is equivocal. Most data on coronary calcification have been obtained with electron-beam CT, but recently multislice CT, which is more versatile, less expensive, and available in most large hospitals, has been increasingly used.
STARTING POINT: Leslee Shaw and colleagues (Radiology 2003; 228: 826-33) showed that the coronary calcification score predicted total mortality within subsets of patients classified at low, intermediate, or high risk according to Framingham criteria. In a cohort of over 10000 individuals, 5-year risk-adjusted survival was 95% when the score was over 1000 compared with 99% for scores of 10 or less. These results agree with other recent studies showing strong correlations between coronary calcification and coronary heart disease events. WHERE NEXT? The increasing use of multislice CT scanners should generate more data for comparison with those obtained from electron-beam CT. Radiation dose, which is higher with multislice than with electron-beam procedures, needs to be reduced, and calcification in scans needs to be quantified more accurately than with existing computer-based analyses. Further studies are needed to establish the predictive power of the coronary calcification score for clinical events and the effects of therapeutic intervention on both these outcomes. It would also be worth investigating the relation between coronary calcification and risk factors not quantified in Framingham-based estimates, including familial and racial predisposition to premature coronary heart disease.
G R Thompson; J Partridge
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Lancet     Volume:  363     ISSN:  1474-547X     ISO Abbreviation:  Lancet     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-20     Completed Date:  2004-03-30     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  557-9     Citation Subset:  AIM; IM    
Metabolic Medicine, Division of Investigative Science, Faculty of Medicine, Imperial College, Hammersmith Hospital, London W12 ONN, UK.
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MeSH Terms
Calcinosis / prevention & control,  radiography*
Coronary Disease / prevention & control,  radiography*
Middle Aged
Risk Assessment / statistics & numerical data
Risk Factors
Severity of Illness Index
Tomography Scanners, X-Ray Computed / statistics & numerical data
Tomography, X-Ray Computed / methods*,  statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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