PURPOSE: To investigate the use of electron beam tomography (EBT) screening to predict all-cause mortality in a large cohort of asymptomatic women and men. METHODS AND RESULTS: We obtained mortality information from the National Death Index in 10377 asymptomatic individuals (40% women) referred by primary care physicians for coronary calcification screening. The average follow-up period was 5 +/- 3.5 years. Univariable and multivariable Cox proportional hazard models were developed to predict all-cause mortality. Women had a lower prevalence of coronary calcification and smaller calcification scores than men (p < 0.0001). Death rates were higher among older, diabetic, hypertensive, and currently smoking individuals both in women and in men. In unadjusted (chi-square = 82, p < 0.0001) as well as risk-adjusted (chi-square = 7, p = 0.007) Cox survival models, women had a greater probability of death than men in each strata of calcification. Relative risk (RR) ratios were increased 3.0-fold, 5.5-fold, and 5.5-fold, respectively, for women compared with men with coronary calcification scores of 101-399, 400-1000, and >1000 (p < 0.0001). Using receiver operating characteristics (ROC) curve analyses to assess coronary calcification added incremental prognostic value to Framingham risk scores (p < 0.0001). CONCLUSIONS: In this cohort of asymptomatic women, coronary calcification screening provided incremental prognostic information after adjustment for traditional risk factors. EBT may be a useful tool for risk stratification in women, where the early diagnosis of coronary heart disease (CHD) remains a strong challenge.
PURPOSE: To investigate the use of electron beam tomography (EBT) screening to predict all-cause mortality in a large cohort of asymptomatic women and men. METHODS AND RESULTS: We obtained mortality information from the National Death Index in 10377 asymptomatic individuals (40% women) referred by primary care physicians for coronary calcification screening. The average follow-up period was 5 +/- 3.5 years. Univariable and multivariable Cox proportional hazard models were developed to predict all-cause mortality. Women had a lower prevalence of coronary calcification and smaller calcification scores than men (p < 0.0001). Death rates were higher among older, diabetic, hypertensive, and currently smoking individuals both in women and in men. In unadjusted (chi-square = 82, p < 0.0001) as well as risk-adjusted (chi-square = 7, p = 0.007) Cox survival models, women had a greater probability of death than men in each strata of calcification. Relative risk (RR) ratios were increased 3.0-fold, 5.5-fold, and 5.5-fold, respectively, for women compared with men with coronary calcification scores of 101-399, 400-1000, and >1000 (p < 0.0001). Using receiver operating characteristics (ROC) curve analyses to assess coronary calcification added incremental prognostic value to Framingham risk scores (p < 0.0001). CONCLUSIONS: In this cohort of asymptomatic women, coronary calcification screening provided incremental prognostic information after adjustment for traditional risk factors. EBT may be a useful tool for risk stratification in women, where the early diagnosis of coronary heart disease (CHD) remains a strong challenge.
Authors: C Noel Bairey Merz; Saralyn Mark; Barbara D Boyan; Alice K Jacobs; Prediman K Shah; Leslee J Shaw; Doris Taylor; Eduardo Marbán Journal: J Womens Health (Larchmt) Date: 2010-06 Impact factor: 2.681
Authors: Lewis H Kuller; Andrea M Kriska; Laura S Kinzel; Laurey R Simkin-Silverman; Kim Sutton-Tyrrell; B Delia Johnson; Molly B Conroy Journal: Contemp Clin Trials Date: 2006-10-14 Impact factor: 2.226
Authors: Matthijs Oudkerk; Arthur E Stillman; Sandra S Halliburton; Willi A Kalender; Stefan Möhlenkamp; Cynthia H McCollough; Rozemarijn Vliegenthart; Leslee J Shaw; William Stanford; Allen J Taylor; Peter M A van Ooijen; Lewis Wexler; Paolo Raggi Journal: Eur Radiol Date: 2008-07-24 Impact factor: 5.315
Authors: Leslee J Shaw; James K Min; Khurram Nasir; Joe X Xie; Daniel S Berman; Michael D Miedema; Seamus P Whelton; Zeina A Dardari; Alan Rozanski; John Rumberger; C Noel Bairey Merz; Mouaz H Al-Mallah; Matthew J Budoff; Michael J Blaha Journal: Eur Heart J Date: 2018-11-01 Impact factor: 29.983