Document Detail

Thoracic aortic calcium versus coronary artery calcium for the prediction of coronary heart disease and cardiovascular disease events.
MedLine Citation:
PMID:  19356578     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study compared the ability of coronary artery calcium (CAC) and thoracic aortic calcium (TAC) to predict coronary heart disease (CHD) and cardiovascular disease (CVD) events. BACKGROUND: Coronary artery calcium has been shown to strongly predict CHD and CVD events, but it is unknown whether TAC, also measured within a single cardiac computed tomography (CT) scan, is of further value in predicting events. METHODS: A total of 2,303 asymptomatic adults (mean age 55.7 years, 38% female) with CT scans were followed up for 4.4 years for CHD (myocardial infarction, cardiac death, or late revascularizations) and CVD (CHD plus stroke). Cox regression, adjusted for Framingham risk score (FRS), examined the relation of Agatston CAC and TAC categories, and log-transformed CAC and TAC with the incidence of CHD and CVD events and receiver-operator characteristic (ROC) curves tested whether TAC improved prediction of events over CAC and FRS. RESULTS: A total of 53% of subjects had Agatston CAC scores of 0; 8% 1 to 9; 19% 10 to 99; 12% 100 to 399; and 8% > or =400. For TAC, proportions were 69%, 5%, 12%, 8%, and 7%, respectively; 41 subjects (1.8%) experienced CHD and 47 (2.0%) CVD events. The FRS-adjusted hazard ratios (HR) across increasing CAC groups (relative to <10) ranged from 3.7 (p = 0.04) to 19.6 (p < 0.001) for CHD and from 2.8 (p = 0.07) to 13.1 (p < 0.001) for CVD events; only TAC scores of 100 to 399 predicted CHD and CVD (HR: 3.0, p = 0.008, and HR: 2.3, p = 0.04, respectively); these risks were attenuated after accounting for CAC. Findings were consistent when using log-transformed CAC and TAC Agatston and volume scores. The ROC curve analyses showed CAC predicted CHD and CVD events over FRS alone (p < 0.01); however, TAC did not further add to predicting events over FRS or CAC. CONCLUSIONS: This study found that CAC, but not TAC, is strongly related to CHD and CVD events. Moreover, TAC does not further improve event prediction over CAC.
Nathan D Wong; Heidi Gransar; Leslee Shaw; Donna Polk; Johanna H Moon; Romalisa Miranda-Peats; Sean W Hayes; Louise E J Thomson; Alan Rozanski; John D Friedman; Daniel S Berman
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Publication Detail:
Type:  Comparative Study; Journal Article; 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 Mar 
Date Detail:
Created Date:  2009-04-09     Completed Date:  2009-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  319-26     Citation Subset:  IM    
Division of Cardiology, University of California, Irvine, California, USA.
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MeSH Terms
Aorta, Thoracic / radiography*
Aortic Diseases / complications,  mortality,  radiography*
Aortography / methods*
Calcinosis / complications,  mortality,  radiography*
Cardiovascular Diseases / etiology*,  mortality,  radiography
Coronary Angiography / methods*
Coronary Artery Disease / complications,  mortality,  radiography*
Databases as Topic
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
ROC Curve
Radiographic Image Interpretation, Computer-Assisted
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed*

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

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