Related Experiment Videos
Coronary calcium and standard risk factors in symptomatic patients referred for coronary angiography
J Kennedy1, R Shavelle, S Wang
1Department of Medicine, Harbor-UCLA Medical Center, Torrance, Calif 90502, USA.
Insights
Coronary calcification is a stronger predictor of obstructive coronary artery disease than traditional risk factors in symptomatic patients. This finding improves diagnosis for patients undergoing coronary angiography.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Obstructive coronary artery disease (CAD) diagnosis relies on traditional risk factors.
- Accurate risk stratification is crucial for symptomatic patients.
- Electron beam computed tomography (EBCT) offers quantitative imaging of coronary calcification.
Purpose of the Study:
- To compare the predictive power of coronary calcification with traditional risk factors.
- To assess their independent value in diagnosing obstructive CAD.
- To evaluate diagnostic accuracy in symptomatic patients undergoing coronary angiography.
Main Methods:
- 368 symptomatic patients underwent coronary angiography and EBCT.
- Coronary risk factors were collected for all participants.
- Bivariate and multivariate analyses were employed to assess predictive values.
Main Results:
- Coronary calcification and male sex were independent predictors of obstructive CAD (p=0.001).
- Coronary calcification demonstrated a higher predictive accuracy than other risk factors.
- A negative predictive value of 90% was observed for patients without coronary calcification.
Conclusions:
- Coronary calcification is a superior predictor of obstructive CAD compared to standard risk factors.
- Quantitative assessment of coronary calcification enhances diagnostic accuracy in symptomatic patients.
- EBCT-derived coronary calcification aids in risk stratification for obstructive CAD.
Objectives:
The purpose of this study was to compare quantitative estimates of coronary calcification with traditional coronary risk factors to determine their independent predictive power for the diagnosis of obstructive angiographic coronary artery disease in symptomatic patients.
Methods:
Three hundred sixty-eight symptomatic patients underwent coronary angiography and electron beam computed tomography at four different centers between April 1989 and December 1993. A blinded cardiologist interpreted the electron beam computed tomograms. Coronary risk factors were obtained in all 368 patients. Both bivariate and multivariate analyses were used to investigate the relation between risk factors and angiographic disease.
Results:
One hundred fifty-eight patients (43%) had angiographically obstructive coronary artery disease (>50% luminal stenosis) and 297 (81%) had coronary calcification. At the bivariate level, only male sex and log-transformed coronary calcification were predictive of angiographic disease (p = 0.008, p = 0.001). By multivariate analysis, only male sex and coronary calcification were predictive (p = 0.001, p = 0.001). Sixty-four of the 71 patients without coronary calcification did not have disease, yielding a negative predictive value of 90%. Receiver operating characteristic curve analysis showed that the amount of coronary calcium was a significantly better discriminator of disease than were the other risk factors.
Conclusions:
Coronary calcification is a stronger predictor of angiographic coronary artery disease in symptomatic patients undergoing angiography than are standard risk factors.