Document Detail


Relationship between baseline coronary calcium score and demonstration of coronary artery stenoses during follow-up MESA (Multi-Ethnic Study of Atherosclerosis).
MedLine Citation:
PMID:  19833306     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The MESA (Multi-Ethnic Study of Atherosclerosis) is a population-based study of 6,814 men and women. We sought to analyze the relationship between the extent of coronary artery calcium (CAC) at baseline and the severity of coronary stenoses in clinically indicated coronary angiography studies during follow-up.
BACKGROUND: CAC is an established predictor of major cardiovascular events. Yet, the relationship between CAC and the distribution and severity of coronary artery stenoses has not been widely explored.
METHODS: All MESA participants underwent noncontrast enhanced cardiac computed tomography during enrollment to determine baseline CAC. We analyzed 175 consecutive angiography reports from participants who underwent coronary catheterization for clinical indications during a median follow-up period of 18 months. The relationship between baseline CAC and the severity of coronary stenosis detected in coronary angiographies was determined.
RESULTS: Baseline Agatston score was 0 in only 7 of 175 (4%) MESA participants who underwent invasive angiography during follow-up. When coronary arteries were studied separately, 13% to 18% of coronary arteries with >or=75% stenosis had 0 calcium mass scores at baseline. There was close association between baseline calcium mass score and the severity of stenosis in each of the coronary arteries (test for trend, p < 0.001). For example, mean calcium mass scores for <50%, 50% to 74%, and >or=75% stenosis in the left anterior descending coronary artery were 105.1 mg, 157.2 mg, and 302.2 mg, respectively (p < 0.001). Finally, there was a direct relationship between the total Agatston Score at baseline and the number of diseased vessels (test for trend, p < 0.001).
CONCLUSIONS: The majority of patients with clinically indicated coronary angiography during follow-up had detectable coronary calcification at baseline. Although there is a significant relationship between the extent of calcification and mean degree of stenosis in individual coronary vessels, 16% of the coronary arteries with significant stenoses had no calcification at baseline.
Authors:
Boaz D Rosen; Veronica Fernandes; Robyn L McClelland; Jeffrey J Carr; Robert Detrano; David A Bluemke; João A C Lima
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  2     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-16     Completed Date:  2010-01-19     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1175-83     Citation Subset:  IM    
Affiliation:
Cardiology Division, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atherosclerosis / complications*,  ethnology,  radiography
Calcinosis / ethnology,  etiology,  radiography*
Coronary Angiography / methods*
Coronary Stenosis / ethnology,  etiology,  radiography*
Disease Progression
Ethnic Groups
Female
Humans
Male
Middle Aged
Population Surveillance
Predictive Value of Tests
Prognosis
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed*
United States
Grant Support
ID/Acronym/Agency:
N01-HC-95159/HC/NHLBI NIH HHS; N01-HC-95166/HC/NHLBI NIH HHS; N01-HC-95168/HC/NHLBI NIH HHS; N01-HC-95169/HC/NHLBI NIH HHS; R01 HL066075-06/HL/NHLBI NIH HHS; R01-HL6607-01/HL/NHLBI NIH HHS; R01-HL66075-01/HL/NHLBI NIH HHS; Z99 CL999999/CL/CLC NIH HHS; ZIA CL090019-01/CL/CLC NIH HHS; ZIA EB000072-01/EB/NIBIB NIH HHS
Comments/Corrections
Comment In:
JACC Cardiovasc Imaging. 2009 Oct;2(10):1184-6   [PMID:  19833307 ]

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