Relation of coronary calcium determined by electron beam computed tomography and lumen narrowing determined by autopsy

Rumberger, John A.; Schwartz, Robert S.; Simons, D.Brent; Sheedy, Patrick F.; Edwards, William D.; Fitzpatrick, Lorraine A.

doi:10.1016/0002-9149(94)90176-7

Cited by 194 publications

(74 citation statements)

References 10 publications

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“…Arterial intimal calcifications are almost invariably an indicator of atherosclerotic disease [1], and a linear relationship exists between calcium area and total plaque area [26,27]. With increasing burden, compensatory remodeling with arterial enlargement can occur, which prevents luminal stenosis [28].…”

Section: Discussionmentioning

confidence: 99%

Carotid Artery Calcification on CT May Independently Predict Stroke Risk

Nandalur

Baskurt

Hagspiel

et al. 2006

American Journal of Roentgenology

122

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OBJECTIVE-The purpose of our study was to quantitatively evaluate calcified atherosclerotic burden in the cervical carotid arteries using MDCT to determine the relationship of scores with luminal stenosis and symptomatology.MATERIALS AND METHODS-Calcium plaque volume was measured in 106 cervical carotid arteries (53 patients) using MDCT angiography. The study group included 32 asymptomatic patients (mean age, 70.2 ± 8.7 [SD] years; 15 women, 17 men) and 21 patients with ischemic neurologic symptoms (69.6 ± 12.9 years; eight women, 13 men). By vessel, there were 43 high-grade stenotic (≥ 60% by North American Symptomatic Carotid Endarterectomy Trial [NASCET] criteria), 15 moderate-grade stenotic (30-59%), and 44 mild-grade stenotic or normal (0-29%) vessels, with four excluded for prior carotid endarterectomy. Volume scores were calculated by summing the area of calcium in the common and extracranial internal carotid arteries on axial slices and multiplying by the slice increment.RESULTS-Controlling for cardiovascular risk factors and luminal stenosis, we found that scores were significantly related to the occurrence of symptoms (p = 0.003). Even with patient age as a covariant, patients with high-grade stenosis had significantly higher scores than those without highgrade disease (p = 0.004). Moreover, quantitative burden was associated with luminal stenosis on adjusted multivariate analysis (p = 0.034). The specificity and positive predictive value for highgrade luminal narrowing were notably lower on individual vessel analysis than on total score analysis, likely secondary to variability in vascular remodeling.CONCLUSION-Calcium scores in the cervical carotid arteries may represent an independent marker for luminal stenosis and ischemic symptoms. A prospective longitudinal study examining calcium levels and morbidity may be warranted to examine whether burden has a role in risk stratification. KeywordsCT arteriography; calcium; carotid; stroke Vascular calcium deposits have recently become a major research and public interest secondary to increasing evidence of the relationship of calcium scores with atherosclerotic burden and clinical outcome. The prevailing example involves coronary calcium scores measured on CT, which have been associated with luminal stenosis [1], overall coronary atherosclerotic load

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Section: Discussionmentioning

confidence: 99%

Carotid Artery Calcification on CT May Independently Predict Stroke Risk

Nandalur

Baskurt

Hagspiel

et al. 2006

American Journal of Roentgenology

122

View full text Add to dashboard Cite

show abstract

“…Measurement of coronary artery calcium (CAC) is the most widely used approach (Greenland et al 2007). CAC is strongly correlated with coronary artery plaque burden (Rumberger et al 1994(Rumberger et al , 1995Budoff et al 1996;Guerci et al 1997;Schmermund et al 1998). Carotid artery sonography is another methodology, although it does not have as much predictive power for CHD events as does CAC (O'Leary et al 1999;Folsom et al 2008;Nambi et al 2010).…”

Section: Risk Assessment By Atherosclerosis Imagingmentioning

confidence: 99%

An International Atherosclerosis Society Position Paper: Global recommendations for the management of dyslipidemia

Grundy

2013

Journal of Clinical Lipidology

149

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“…19 Two reports, one a histopathologic study 28 and the other a clinical study, 31 have shown that, when matched for severity of luminal disease, EBCT coronary calcium area or score has similar predictive values in men and women. Thus, similar calcium scores are diagnostic of similar overall atherosclerotic plaque burdens, regardless of age and gender.…”

Section: Calcium Scores Age and Gendermentioning

confidence: 99%