Author + information
- Received October 21, 1997
- Revision received January 16, 1998
- Accepted January 26, 1998
- Published online May 1, 1998.
- Axel Schmermund, MDAC,* (, )
- Dietrich Baumgart, MDA,
- Günter Görge, MDA,
- Dietrich Grönemeyer, MDB,
- Rainer Seibel, MDB,
- Kent R. Bailey, PhDC,
- John A. Rumberger, PhD, MD, FACCC,
- Dietrich Paar, MDA and
- Raimund Erbel, MD, FACCA
- ↵*Dr. Axel Schmermund, Mayo Clinic and Foundation, Cardiovascular Diseases, W-16A Mayo, 200 First Street SW, Rochester, Minnesota 55905.
Objectives. This study sought to determine whether noninvasive quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of cardiovascular risk factors on coronary atherosclerosis.
Background. Electron beam computed tomography (EBCT) allows the delineation of anatomic coronary atherosclerotic disease and may be useful for noninvasively defining the role of established and new cardiovascular risk factors in selected patient groups.
Methods. A total of 211 consecutive patients, 26 to 79 years old, referred for evaluation of suspected or recently diagnosed coronary artery disease were examined. Selective coronary angiography was used to define five angiographic disease categories: normal coronary arteries, nonobstructive disease and one-, two- or three-vessel disease. EBCT was used to calculate coronary calcium scores, and cardiovascular risk, including lipid variables and fibrinogen levels, was assessed.
Results. Coronary calcium score and angiographic disease severity categories were largely predicted by identical risk factors (i.e., age, male gender, total/high density lipoprotein cholesterol ratio, fibrinogen) and, to a lesser degree, hypertension. Only smoking predicted angiographic disease severity but not calcium scores. The risk factors together explained a comparable proportion of the variability in angiographic disease categories and in calcium score quintiles (33% vs. 41%, p = 0.16 by bootstrap analysis). An overall risk score composed of these risk factors separated angiographic disease categories and calcium score quintiles with a similar area under the receiver operating characteristic curve ([mean ± SE] 0.81 ± 0.03 vs. 0.83 ± 0.03, p = NS).
Conclusions. Quantification of coronary calcium is comparable to selective coronary angiography in measuring the effect of established cardiovascular risk factors on coronary atherosclerosis. Thus, EBCT may be useful for the noninvasive evaluation of the relations between conventional or developing cardiovascular risk factors and coronary atherosclerosis.
- Received October 21, 1997.
- Revision received January 16, 1998.
- Accepted January 26, 1998.
- The American College of Cardiology