Ultrafast computed tomography-detected coronary calcium reflects the angiographic extent of coronary arterial atherosclerosis

Agatston, Arthur S.; Janowitz, Warren R.; Kaplan, Glenn; Gasso, Julius; Hildner, Frank J.; Viamonte, Manual

doi:10.1016/0002-9149(94)90563-0

Cited by 92 publications

(45 citation statements)

References 18 publications

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“…The results of EBT scanning have been validated against angiographic (Agatston, Janowitz, Kaplan, Gasso, Hildner, & Viamonte, 1994;Budoff, Georgiou, Broday, Agatston, Kennedy, et al 1996) and histological (Mautner, Mautner, Froelich, Feuerstein, Proschan, et al, 1994) methods for evaluating CHD. EBT was found to be as sensitive as established methods in detecting clinically significant coronary atherosclerosis (e.g., Rumberger, Schwartz, Simons, Sheedy, Edwards, & Fitzpatrick, 1994).…”

Section: Methodsmentioning

confidence: 99%

Cardiac anxiety in people with and without coronary atherosclerosis

2008

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Many studies have shown that cardiac anxiety when occurring in the absence of coronary artery disease is common and quite costly. The Cardiac Anxiety Questionnaire (CAQ) is an 18 item selfreport measure that assesses anxiety related to cardiac symptoms. In order to better understand the construct of cardiac anxiety, a factor analysis was conducted on CAQ data from 658 individuals who were self-or physician-referred for electron beam tomographic screening to determine whether clinically significant coronary atherosclerosis was present. A four-factor solution was judged to provide the best fit with the results reflecting the following factor composition: heart focused attention, avoidance of activities that bring on symptoms, worry or fear regarding symptoms, and reassurance-seeking. Factorial invariance across groups was also assessed to determine whether the factor structure of the CAQ was similar in individuals with and without clear evidence of coronary atherosclerosis. The factor structure of the CAQ did not differ between the two groups. However, the group without coronary atherosclerosis had significantly higher mean scores on their attention and worry/fear factors suggesting that people without a diagnosed cardiac condition pay more attention to and worry more about their cardiac related symptoms than those people who have coronary atherosclerosis. KeywordsAnxiety sensitivity; cardiac; anxiety; confirmatory factor analysis; factorial invariance; configural invariance; metric invariance Fear of bodily sensations, one component of anxiety sensitivity, has been found to play a central role in panic disorder (Cox, 1996;McNally &Eke, 1996;Reiss and McNally, 1985) and is likely to play a role in its etiology (Schmidt, Lerew, & Jackson, 1997) and persistence over time (Clark, 1988). Fear of anxiety sensations, as measured by the Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986), has been shown to reflect specific dimensions referring to somatic, social, and psychological consequences (e.g., Zinbarg, Brown, & Barlow, 1997). Taylor and Cox (1998) found that an expanded measure of anxiety sensitivity, the Anxiety Sensitivity Profile (ASP), included four lower-order factors composed of items that assess bodily sensations pertaining to fears of respiratory, cardiac, cognitive, and gastrointestinal symptoms. Based upon such evidence, researchers are increasingly exploring the possibility that a fear of certain bodily sensations may be a psychological risk factor for other types of anxiety pathology (e.g., Eifert, 1992;Zinbarg, Mohlman, & Hong, 1999).There has been a considerable amount of research examining the relationship between anxiety, usually in the form of panic disorder and chest pain (e.g., Beck, Berisford, Taegtmeyer, & Bennett, 1990;Beitman, Mukerji, Lamberti, Schmid, DeRosear, et al., 1989). This phenomenon is often referred to as non-cardiac chest pain. Many of these studies have focused exclusively on chest pain as a primary symptom, because the potential seriousness of thi...

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Section: Methodsmentioning

confidence: 99%

Cardiac anxiety in people with and without coronary atherosclerosis

2008

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“…Although correlation between calcium score as measured by EBCT and extent of coronary atherosclerosis has been demonstrated, 21 support for EBCT as a surrogate of clinical outcomes with therapeutic intervention all but disappeared after the results of the Beyond Endorsed Lipid Lowering with EBCT Scanning (BELLES) trial. 22 BELLES did not demonstrate any differences in coronary calcium score changes between moderate and aggressive lipid-lowering strategies despite differences in clinical outcomes demonstrated with the same treatments.…”

Section: Cardiovascular Imaging: Current Utility and Future Directionmentioning

confidence: 99%

Vascular Biomarkers and Surrogates in Cardiovascular Disease

et al. 2006

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Abstract-Cardiovascular biomarker research efforts have resulted in the identification of new risk factors and novel drug targets, as well as the establishment of treatment guidelines. Government agencies, academic research institutions, diagnostic industries, and pharmaceutical companies all recognize the importance of biomarkers in advancing therapies to improve public health. In drug development, biomarkers are used to evaluate early signals of efficacy and safety, to select dose, and to identify the target population. The United States Food and Drug Administration has relied on biomarkers to support clinical applications in many therapeutic fields, including cardiovascular disease. The appropriate application of cardiovascular biomarkers requires an understanding of disease natural history, the mechanism of the intervention, and the characteristics and limitations of the biomarker. Channels of communication among researcher, developer, and regulator must remain open to maximize the success of future biomarker efforts. In

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“…2,7,8 Coronary artery calcification has shown good correlation with angiographically diagnosed CAD. 9 The ability to noninvasively quantify coronary artery calcium (CAC) by using electron-beam tomography (EBT) offers the potential to address some of the issues related to prevalence of CAD in specific populations and the relationship of CAD to (and possible interactions with) risk factors. Reports on differences in CAC by race are just beginning to emerge.…”

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confidence: 99%

Racial Differences in Coronary Artery Calcification in Older Adults

Newman

Naydeck

Whittle

et al. 2002

ATVB

120

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Abstract-Reports on race-related differences in coronary artery calcium (CAC) are just beginning to emerge and have not been well studied in the elderly. This study was undertaken to assess whether such differences exist and the relationship between CAC and cardiovascular risk factors in a cohort of elderly community-dwelling adults. CAC was measured by using electron-beam tomography in 614 adults (aged 67 to 99 years), of whom 59% were women and 23% were black. The median CAC score was lower in blacks than in whites for men (159 versus 787, respectively; PϽ0.001) and for women (134 versus 233, respectively; Pϭ0.02) after adjustment for age, cardiovascular disease, and risk factors for cardiovascular disease, although this difference was stronger and remained significant among men only. Lower CAC scores were also observed in the subgroup of blacks with a history of myocardial infarction. The lower CAC scores in blacks compared with whites observed in this study is consistent with either a lower prevalence of coronary artery disease or a lower extent of calcification of coronary artery disease. Key Words: coronary artery calcification Ⅲ race Ⅲ elderly Ⅲ cardiovascular disease T here is still uncertainty regarding differences between blacks and whites in the prevalence, progression, and risk of coronary artery disease (CAD). Mortality rates from CAD are higher in black women than in white women, 1 and blacks with acute myocardial infarction (MI) have been reported to have poorer survival after hospitalization in some, though not all, studies. 2,3 Compared with whites, blacks tend to have more carotid disease and left ventricular hypertrophy by noninvasive testing, 4 yet blacks undergoing angiography for clinical symptoms tend to have a lower extent of coronary disease than do whites. 5 Moreover, there is evidence that the patterns of CAD have evolved in these groups over time, perhaps in different ways, complicating the simultaneous interpretation of current and earlier studies. See page 359Blacks have higher rates of hypertension 6 and diabetes 2 than do whites. In a cohort of older adults, blacks, compared with whites, had a higher prevalence of clinical cardiovascular disease (CVD) and a similar prevalence of subclinical CVD, which were largely explained by the higher prevalence of risk factors. 4 These risk factors might be expected to lead to a higher prevalence of CAD. 2,7,8 Coronary artery calcification has shown good correlation with angiographically diagnosed CAD. 9 The ability to noninvasively quantify coronary artery calcium (CAC) by using electron-beam tomography (EBT) offers the potential to address some of the issues related to prevalence of CAD in specific populations and the relationship of CAD to (and possible interactions with) risk factors. Reports on differences in CAC by race are just beginning to emerge. Two studies using EBT 10,11 reported similar levels of calcium in blacks and whites, whereas 1 fluoroscopy study reported a lower prevalence of calcification in a middle-aged, predominantly m...

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Ultrafast computed tomography-detected coronary calcium reflects the angiographic extent of coronary arterial atherosclerosis

Cited by 92 publications

References 18 publications

Cardiac anxiety in people with and without coronary atherosclerosis

Cardiac anxiety in people with and without coronary atherosclerosis

Vascular Biomarkers and Surrogates in Cardiovascular Disease

Racial Differences in Coronary Artery Calcification in Older Adults

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