OBJECTIVES: We sought to examine the independent predictive value of coronary artery calcium detection for coronary outcomes in a non-referred cohort of healthy men and women ages 40 to 50 years. BACKGROUND: Existing studies have suggested that coronary calcium might have incremental predictive value for coronary outcomes above standard coronary risk factors. However, additional data from non-referred and younger populations are needed. METHODS: Participants (n = 2,000; mean age 43 years) were evaluated with measured coronary risk variables and coronary calcium detected with electron beam tomography. Incident acute coronary syndromes and sudden cardiac death were ascertained via annual telephonic contacts, with follow-up (mean, 3.0 +/- 1.4 years; range, 1 to 6 years) in 99.2% of the cohort. RESULTS: Coronary calcium was found in 22.4% of men and 7.9% of women. A total of 9 acute events occurred in men at a mean age of 46 years, including 7 of 364 men with coronary calcium (1.95%) and 2 of 1,263 men without coronary calcium (0.16%; p < 0.0001 by log-rank). No events occurred in women. In these men, coronary calcium was associated with an 11.8-fold increased risk for incident coronary heart disease (CHD) (p = 0.002) in a Cox model controlling for the Framingham risk score. Among those with coronary artery calcification, the risk of coronary events increased incrementally across tertiles of coronary calcium severity (hazard ratio 4.3 per tertile). A family history of premature CHD was also predictive of incident events. The marginal cost effectiveness, assuming a 30% improvement in survival associated with primary prevention among at-risk men, was modeled to be 37,633 dollars per quality-adjusted life year saved. CONCLUSIONS: In young, asymptomatic men, the presence of coronary artery calcification provides substantial, cost-effective, independent prognostic value in predicting incident CHD that is incremental to measured coronary risk factors.
OBJECTIVES: We sought to examine the independent predictive value of coronary artery calcium detection for coronary outcomes in a non-referred cohort of healthy men and women ages 40 to 50 years. BACKGROUND: Existing studies have suggested that coronary calcium might have incremental predictive value for coronary outcomes above standard coronary risk factors. However, additional data from non-referred and younger populations are needed. METHODS:Participants (n = 2,000; mean age 43 years) were evaluated with measured coronary risk variables and coronary calcium detected with electron beam tomography. Incident acute coronary syndromes and sudden cardiac death were ascertained via annual telephonic contacts, with follow-up (mean, 3.0 +/- 1.4 years; range, 1 to 6 years) in 99.2% of the cohort. RESULTS: Coronary calcium was found in 22.4% of men and 7.9% of women. A total of 9 acute events occurred in men at a mean age of 46 years, including 7 of 364 men with coronary calcium (1.95%) and 2 of 1,263 men without coronary calcium (0.16%; p < 0.0001 by log-rank). No events occurred in women. In these men, coronary calcium was associated with an 11.8-fold increased risk for incident coronary heart disease (CHD) (p = 0.002) in a Cox model controlling for the Framingham risk score. Among those with coronary artery calcification, the risk of coronary events increased incrementally across tertiles of coronary calcium severity (hazard ratio 4.3 per tertile). A family history of premature CHD was also predictive of incident events. The marginal cost effectiveness, assuming a 30% improvement in survival associated with primary prevention among at-risk men, was modeled to be 37,633 dollars per quality-adjusted life year saved. CONCLUSIONS: In young, asymptomatic men, the presence of coronary artery calcification provides substantial, cost-effective, independent prognostic value in predicting incident CHD that is incremental to measured coronary risk factors.
Authors: Tochi M Okwuosa; Philip Greenland; Gregory L Burke; John Eng; Mary Cushman; Erin D Michos; Hongyan Ning; Donald M Lloyd-Jones Journal: JACC Cardiovasc Imaging Date: 2012-02
Authors: Patrick M Colletti; Laurie D Dustin; Nathan D Wong; Jabi E Shriki; Miwa Kawakubo; Stanley P Azen; Robert C Detrano Journal: Radiology Date: 2010-08-16 Impact factor: 11.105
Authors: Donghee Kim; Su-Yeon Choi; Eun Ha Park; Whal Lee; Jin Hwa Kang; Won Kim; Yoon Jun Kim; Jung-Hwan Yoon; Sook Hyang Jeong; Dong Ho Lee; Hyo-suk Lee; Joseph Larson; Terry M Therneau; W Ray Kim Journal: Hepatology Date: 2012-07-02 Impact factor: 17.425
Authors: Ramzi Dudum; Omar Dzaye; Mohammadhassan Mirbolouk; Zeina A Dardari; Olusola A Orimoloye; Matthew J Budoff; Daniel S Berman; Alan Rozanski; Michael D Miedema; Khurram Nasir; John A Rumberger; Leslee Shaw; Seamus P Whelton; Garth Graham; Michael J Blaha Journal: J Cardiovasc Comput Tomogr Date: 2019-03-27
Authors: Kevin A Bybee; John Lee; Richard Markiewicz; Ryan Longmore; A Iain McGhie; James H O'Keefe; Bai-Ling Hsu; Kevin Kennedy; Randall C Thompson; Timothy M Bateman Journal: J Nucl Cardiol Date: 2009-12-11 Impact factor: 5.952
Authors: Arvind K Pandey; Michael J Blaha; Kavita Sharma; Juan Rivera; Matthew J Budoff; Ron Blankstein; Mouaz Al-Mallah; Nathan D Wong; Leslee Shaw; Jeffery Carr; Daniel O'Leary; Joao A C Lima; Moyses Szklo; Roger S Blumenthal; Khurram Nasir Journal: Atherosclerosis Date: 2013-12-06 Impact factor: 5.162