Document Detail

Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam computed tomography.
MedLine Citation:
PMID:  10694523     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is a clear relationship between absolute calcium scores (CS) and severity of coronary artery disease. However, hard coronary events have been shown to occur across all ranges of CS. METHODS AND RESULTS: We conducted 2 analyses: in group A, 172 patients underwent electron-beam CT (EBCT) imaging within 60 days of suffering an unheralded myocardial infarction. In group B, 632 patients screened by EBCT were followed up for a mean of 32+/-7 months for the development of acute myocardial infarction or cardiac death. The mean patient age and prevalence of coronary calcification were similar in the 2 groups (53+/-8 versus 52+/-9 years and 96% each). In group B, the annualized event rate was 0.11% for subjects with CS of 0, 2.1% for CS 1 to 99, 4.1% for CS 100 to 400, and 4.8% for CS >400, and only 7% of the patients had CS >400. However, mild, moderate, and extensive absolute CSs were distributed similarly between patients with events in both groups (34%, 35%, and 27%, respectively, in group A and 44%, 30%, and 22% in group B). In contrast, the majority of events in both groups occurred in patients with CS >75th percentile (70% in each group). CONCLUSIONS: Coronary calcium is present in most patients who suffer acute coronary events. Although the event rate is greater for patients with high absolute CSs, few patients have this degree of calcification on a screening EBCT. Conversely, the majority of events occur in individuals with high CS percentiles. Hence, CS percentiles constitute a more effective screening method to stratify individuals at risk.
P Raggi; T Q Callister; B Cooil; Z X He; N J Lippolis; D J Russo; A Zelinger; J J Mahmarian
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  101     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-23     Completed Date:  2000-03-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  850-5     Citation Subset:  AIM; IM    
EBT Research Foundation and Vanderbilt University, Nashville, TN 37075, USA.
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MeSH Terms
Calcinosis / complications,  radiography*
Calcium / analysis*
Cohort Studies
Coronary Disease / complications,  radiography*
Follow-Up Studies
Mass Screening
Middle Aged
Myocardial Infarction / epidemiology*,  etiology,  prevention & control
Retrospective Studies
Tomography, X-Ray Computed / methods*
Reg. No./Substance:
Comment In:
Rev Cardiovasc Med. 2001 Spring;2(2):110-1   [PMID:  12506946 ]

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

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