Role of coronary calcium screening in preventive cardiology.

Over 7 million people in this country have coronary artery disease, and more than 500,000 die from its complications annually. Over 1 million Americans have an acute myocardial infarction each year, and in the majority of cases the event announcing the presence of coronary atherosclerosis is either sudden death or a disabling myocardial infarction. Therefore, the most desirable approach to such an epidemic is prevention rather than delayed treatment. Yet, statistics from primary care and subspecialty practices indicate that the preventive attitude of the majority of physicians is not sufficiently developed and remains limited in most training programs. Though traditional risk factors are very helpful in predicting the development of cardiovascular disease, many individuals suffer events in the absence of established risk factors for atherosclerosis. To meet the challenge of coronary artery disease, several tools have been developed to identify atherosclerotic disease in its preclinical stages in the hope of modifying its natural history. This review deals with the utilization of electron beam tomography for detection of coronary artery calcification as an additional tool available for use by preventive cardiologists and internists.