Coronary Artery Calcification: Pathophysiology, Epidemiology, Imaging Methods, and Clinical Implications

Wexler, Lewis; Brundage, Bruce H.; Crouse, John R.; Detrano, Robert; Fuster, Valentín; Maddahi, Jamshid; Rumberger, John A.; Stanford, William; White, Richard D.; Taubert, Kathryn A.

doi:10.1161/01.cir.94.5.1175

Cited by 986 publications

(582 citation statements)

References 127 publications

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“…5). The median values were lower in absolute value but also very consistent for different reconstruction increments (Median: AgN 110-115, Vol 112-115 mm 3 , Mass 36-38 mg). For the interpolated volume and interpolated mass, however, mean and median value are higher for low image increment.…”

Section: Resultsmentioning

confidence: 67%

“…For the interpolated volume and interpolated mass, however, mean and median value are higher for low image increment. They increase from Mean(Vol I )=261 mm 3 , Median(Vol I )=100 mm 3 , Mean(Mass I )=49 mg, and Median(Mass I )=21 mg for 3-mm image increment to Mean(Vol I )=302 mm 3 , Median(Vol I )=171 mm 3 , Mean(Mass I )=62 mg, and Median(Mass I )=40 mg for 1-mm increment (p<0.001). Agatston-, conventional volume, and conventional mass do not show systematic differences depending on the image increment, interpolated volume, and interpolated mass; however, they systematically provide lower values for small image overlap.…”

Section: Resultsmentioning

confidence: 88%

“…For Agatston scoring, conventional volume, and conventional mass the mean value of all scores from all patients and both acquisitions, including the standard deviation, did not show remarkable variations for different reconstruction increments (Mean: AgN 310-316, Vol 308-312 mm 3 , Mass 60-62 mg; Fig. 5).…”

Section: Resultsmentioning

confidence: 90%

“…The amount of coronary calcification may be used as a marker for the total atherosclerotic plaque burden [3]. Variable amounts of calcification may indicate regression or progression of atherosclerosis and coronary artery disease (CAD) [4].…”

Section: Introductionmentioning

confidence: 99%

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Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT

et al. 2002

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High reproducibility is a key requirement for coronary calcium scoring in follow-up examinations. We investigated the interexamination reproducibility of calcium scoring with retrospectively ECG-gated multisection spiral CT (MSCT). Fifty patients were examined twice with MSCT. Slices were reconstructed with retrospective ECG gating in the diastolic phase with 3-mm slice width and up to 125-ms temporal resolution. We calculated the Agatston score, calcium volume with and without isotropic interpolation, and calcium mass, and derived the mean and median variability. We investigated the change of variability with use of 3-mm nonoverlapping and overlapping increments (2, 1.5, 1 mm). Use of overlapping increment results in considerably reduced interscan variability. We observed a minimum mean variability of 12% and a minimum median variability of 9% for the Agatston score. For volume and mass quantification we obtained a minimum mean variability of 7.5% and a minimum median variability of 5%. Multisection spiral CT enables coronary calcium quantification with high reproducibility in follow-up examinations mainly founded on image data with reduced partial-volume errors due to overlapping increment.

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Section: Resultsmentioning

confidence: 67%

Section: Resultsmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT

et al. 2002

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“…Although researchers are testing different presently available in vivo imaging methods for prediction of angiographically detectable stenosis [2], the tools used in diagnostic procedure of acute coronary syndrome remain the patient's history of chest pain, the specific ECG changes and the elevation of heart enzymes, for example the myoglobin and the troponins [3,4]. The golden standard for the evaluation of the extent of coronary atherosclerosis and the severity of the stenotic lesion is the coronary angiography, which shows the culprit lesion that causes the acute coronary syndrome.…”

Section: Introductionmentioning

confidence: 99%

Virtual coronary cineangiography

Bajec

Trunk

Oseli

et al. 2003

Computers in Biology and Medicine

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The mastering of myocardial infarction diagnosis is traditionally composed of laborious trial-and error-based examination of canonical coronary cineangiographies. In the following article we suggest a system that enables the instructor to generate student-specific cases, thus allowing teaching not only the basic feature searching and stenosis evaluation processes, but also the importance of the correct acquisition viewpoint. With the proposal of the development of the Digital Cardiologist intelligent agent we also envisage the possibility of the student's self tutoring.

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Maximizing the Cost-effectiveness of Lipid-Lowering Therapy

Jacobson¹,

Schein²,

Williamson³

et al. 1998

Arch Intern Med

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Cardiovascular disease, including coronary heart disease, is the leading cause of death both in men and in women in the United States. The purpose of this review is to describe the effectiveness of lipid-lowering therapy in reducing cardiovascular morbidity and mortality, which has recently been extended to patients with mild to moderate hypercholesterolemia, and the cost of providing therapy, which would be prohibitive if all persons with hypercholesterolemia received treatment. Cost-effectiveness analysis provides a rational means of allocating limited health care resources by allowing the comparison of the costs of lipid-lowering therapy, in particular, therapy with beta-hydroxy-beta-methylglutaryl-CoA (coenzyme A) reductase inhibitors (statins), with the costs of atherosclerosis that could be prevented by lowering cholesterol. To extend the benefits of treatment to the large number of persons not receiving therapy, we need to implement more cost-effective treatment by improving risk assessment, increasing treatment effectiveness, and reducing the cost of therapy.

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Coronary Artery Calcification: Pathophysiology, Epidemiology, Imaging Methods, and Clinical Implications

Cited by 986 publications

References 127 publications

Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT

Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ECG-gated multisection spiral CT

Virtual coronary cineangiography

Maximizing the Cost-effectiveness of Lipid-Lowering Therapy

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