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Rates of progression of coronary calcium by electron beam tomography
M J Budoff1, K L Lane, H Bakhsheshi
1Division of Cardiology, Saint John's Cardiovascular Research Center, Harbor-UCLA Medical Center Research and Education Institute, Torrance, CA 90502, USA.
Insights
Electron beam tomography (EBT) assessed coronary calcium score progression in asymptomatic individuals. Statin therapy significantly reduced atherosclerosis progression by 61%, highlighting EBT
Area of Science:
- Cardiovascular Imaging
- Medical Diagnostics
- Pharmacological Research
Background:
- Atherosclerosis progression is a key driver of cardiovascular events.
- Non-invasive imaging modalities are crucial for monitoring disease.
- Coronary calcium scoring quantifies calcific plaque burden.
Purpose of the Study:
- To determine the rate of atherosclerosis progression using coronary calcium scores.
- To evaluate the impact of statin therapy on coronary calcium progression.
- To assess the utility of electron beam tomography (EBT) in monitoring treatment efficacy.
Main Methods:
- 299 asymptomatic individuals underwent two EBT scans at least 12 months apart.
- Coronary calcium scores were calculated using the Agatston method.
- Participants were categorized into treated (statin) and untreated groups.
Main Results:
- The average annual increase in coronary calcium score was 33.2%.
- Statin-treated patients showed a significantly lower progression rate (15%/year) compared to untreated patients (39%/year).
- Statin therapy reduced the rate of coronary calcium progression by 61% and 37% of patients on statin monotherapy showed decreased scores.
Conclusions:
- EBT is a valuable tool for non-invasively assessing atherosclerosis progression.
- Statin therapy effectively retards the progression of coronary atherosclerosis.
- Initial zero coronary calcium scores predict a low likelihood of significant future calcification.
Abstract:
In this study, we sought to determine the rate of progression of atherosclerosis using coronary calcium scores derived from electron beam tomography (EBT). We studied a variety of disease states (hypertension, high cholesterol, tobacco use, diabetes mellitus) followed for 1 to 6.5 years. We evaluated 299 asymptomatic persons (227 men and 72 women) who underwent 2 consecutive EBT scans at least 12 months apart. The average change in the calcium score (Agatston method) for the entire group was 33.2 +/- 9.2%/year. The treated group (receiving statins) demonstrated an average increase in calcium scores of 15 +/- 8%/year compared with 39 +/- 12%/year for untreated patients (p <0.001). Among the 60 patients on statin monotherapy, 37% had a decrease in the calcium score from baseline to follow-up scan. The relative increase in calcium scores did not vary significantly by gender or risk factors, with the exception of statin-treated hypercholesterolemic subjects. Scores of zero on the initial scan portend a low likelihood of significant calcific deposits on repeat scanning. Only 2 of 81 participants (2%) with scores of zero at baseline had scores >10 on repeat study. In this study, statin therapy induced a 61% reduction in the rate of coronary calcium progression. This study demonstrates that EBT may be a useful tool in assessing efficacy of different interventions to retard progression of atherosclerosis, noninvasively, over relatively short time periods.