Quantification of coronary artery calcium by electron beam computed tomography for determination of severity of angiographic coronary artery disease in younger patients
This study attempted to 1) evaluate five quantitative measures of coronary artery calcium and determine which best agreed with coronary artery disease severity at angiography; and 2) determine optimal quantity cutpoints to distinguish among no, mild and significant disease. Coronary artery calcium i...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1995-03, Vol.25 (3), p.626-632 |
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| creator | Kaufmann, Rachel B. Peyser, Patricia A. Sheedy, Patrick F. Rumberger, John A. Schwartz, Robert S. |
| description | This study attempted to 1) evaluate five quantitative measures of coronary artery calcium and determine which best agreed with coronary artery disease severity at angiography; and 2) determine optimal quantity cutpoints to distinguish among no, mild and significant disease.
Coronary artery calcium identified noninvasively by electron beam computed tomography is a sensitive marker for atherosclerosis. Quantitative assessments of calcium could distinguish among patients with no, mild and significant disease in clinical, screening and research settings.
One hundred sixty patients, 23 to 59 years old, underwent coronary angiography and electron beam computed tomography. Coronary artery calciumwas defined as dense (> 130 Hounsfield units) foci ≥2 mm2on the tomogram. Regression and receiver operating characteristic analyses were used to evaluate five quantitative measures of calcium as predictors of the largest stenosis in the coronary arteries and to identify optimal cutpoints for distinguishing among disease categories. No diseasewas defined as no stenosis, mild diseaseas 10% to 49% diameter stenosis in one or more major branches and significant diseaseas ≥ 50% diameter stenosis in one or more major branches.
All measures evaluated performed well. With calcific area as the quantitative measure, the best cutpoint for discriminating between patients with and without disease was the presence of calcium: sensitivity 81%, specificity 86% and overall accuracy 83%. The best cutpoint for discriminating between patients with and without significant disease was 18 mm2: sensitivity 86%, specificity 81% and accuracy 83%.
Because the ranges of calcium quantity overlapped across disease categories, no cutpoints would distinguish among categories with absolute certainty. However, selected cutpoints could rule out disease in most healthy subjects and identify most patients with significant disease. |
| doi_str_mv | 10.1016/0735-1097(94)00435-S |
| format | Article |
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Coronary artery calcium identified noninvasively by electron beam computed tomography is a sensitive marker for atherosclerosis. Quantitative assessments of calcium could distinguish among patients with no, mild and significant disease in clinical, screening and research settings.
One hundred sixty patients, 23 to 59 years old, underwent coronary angiography and electron beam computed tomography. Coronary artery calciumwas defined as dense (> 130 Hounsfield units) foci ≥2 mm2on the tomogram. Regression and receiver operating characteristic analyses were used to evaluate five quantitative measures of calcium as predictors of the largest stenosis in the coronary arteries and to identify optimal cutpoints for distinguishing among disease categories. No diseasewas defined as no stenosis, mild diseaseas 10% to 49% diameter stenosis in one or more major branches and significant diseaseas ≥ 50% diameter stenosis in one or more major branches.
All measures evaluated performed well. With calcific area as the quantitative measure, the best cutpoint for discriminating between patients with and without disease was the presence of calcium: sensitivity 81%, specificity 86% and overall accuracy 83%. The best cutpoint for discriminating between patients with and without significant disease was 18 mm2: sensitivity 86%, specificity 81% and accuracy 83%.
Because the ranges of calcium quantity overlapped across disease categories, no cutpoints would distinguish among categories with absolute certainty. However, selected cutpoints could rule out disease in most healthy subjects and identify most patients with significant disease.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(94)00435-S</identifier><identifier>PMID: 7860906</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Calcinosis - diagnostic imaging ; Calcium - analysis ; Cardiovascular system ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease - diagnostic imaging ; Coronary Disease - metabolism ; Coronary Disease - pathology ; Coronary Vessels - chemistry ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed</subject><ispartof>Journal of the American College of Cardiology, 1995-03, Vol.25 (3), p.626-632</ispartof><rights>1995 American College of Cardiology</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c486t-3325b1f1dd06c83dcc4d91298a1a6af6fbcb42fc87f98a315e9db37b26e541283</citedby><cites>FETCH-LOGICAL-c486t-3325b1f1dd06c83dcc4d91298a1a6af6fbcb42fc87f98a315e9db37b26e541283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0735-1097(94)00435-S$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3469016$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7860906$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaufmann, Rachel B.</creatorcontrib><creatorcontrib>Peyser, Patricia A.</creatorcontrib><creatorcontrib>Sheedy, Patrick F.</creatorcontrib><creatorcontrib>Rumberger, John A.</creatorcontrib><creatorcontrib>Schwartz, Robert S.</creatorcontrib><title>Quantification of coronary artery calcium by electron beam computed tomography for determination of severity of angiographic coronary artery disease in younger patients</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>This study attempted to 1) evaluate five quantitative measures of coronary artery calcium and determine which best agreed with coronary artery disease severity at angiography; and 2) determine optimal quantity cutpoints to distinguish among no, mild and significant disease.
Coronary artery calcium identified noninvasively by electron beam computed tomography is a sensitive marker for atherosclerosis. Quantitative assessments of calcium could distinguish among patients with no, mild and significant disease in clinical, screening and research settings.
One hundred sixty patients, 23 to 59 years old, underwent coronary angiography and electron beam computed tomography. Coronary artery calciumwas defined as dense (> 130 Hounsfield units) foci ≥2 mm2on the tomogram. Regression and receiver operating characteristic analyses were used to evaluate five quantitative measures of calcium as predictors of the largest stenosis in the coronary arteries and to identify optimal cutpoints for distinguishing among disease categories. No diseasewas defined as no stenosis, mild diseaseas 10% to 49% diameter stenosis in one or more major branches and significant diseaseas ≥ 50% diameter stenosis in one or more major branches.
All measures evaluated performed well. With calcific area as the quantitative measure, the best cutpoint for discriminating between patients with and without disease was the presence of calcium: sensitivity 81%, specificity 86% and overall accuracy 83%. The best cutpoint for discriminating between patients with and without significant disease was 18 mm2: sensitivity 86%, specificity 81% and accuracy 83%.
Because the ranges of calcium quantity overlapped across disease categories, no cutpoints would distinguish among categories with absolute certainty. However, selected cutpoints could rule out disease in most healthy subjects and identify most patients with significant disease.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Calcinosis - diagnostic imaging</subject><subject>Calcium - analysis</subject><subject>Cardiovascular system</subject><subject>Constriction, Pathologic</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - metabolism</subject><subject>Coronary Disease - pathology</subject><subject>Coronary Vessels - chemistry</subject><subject>Female</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Tomography, X-Ray Computed</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGO1SAUhonRjHdG30ATFsboogqF0rIxMRNHTSYxZnRNKByumBYq0En6Rj6mXO_N3Zi4OsD5zg_8P0LPKHlDCRVvSc-6hhLZv5L8NSG87u4eoB3tuqFhnewfot0ZeYwuc_5JCBEDlRfooh8EkUTs0O-vqw7FO2908THg6LCJKQadNqxTgVqMnoxfZzxuGCYwpXbxCHqu4LysBSwucY77pJcfG3YxYQt1bvbhrJjhHpIv22Gtw94fYW_-ucr6DDoD9gFvcQ17SHipKhBKfoIeOT1leHqqV-j7zYdv15-a2y8fP1-_v20MH0RpGGu7kTpqLRFmYNYYbiVt5aCpFtoJN5qRt84MvatnjHYg7cj6sRXQcdoO7Aq9POouKf5aIRc1-2xgmnSAuGbV95T3TLIK8iNoUsw5gVNL8nP9jKJEHQJSB_fVwX0lufobkLqrY89P-us4gz0PnRKp_Renvs7VeZd0MD6fMcaFrNoVe3fEoHpx7yGpbKpPBqxPNSNlo___O_4AUJiyTA</recordid><startdate>19950301</startdate><enddate>19950301</enddate><creator>Kaufmann, Rachel B.</creator><creator>Peyser, Patricia A.</creator><creator>Sheedy, Patrick F.</creator><creator>Rumberger, John A.</creator><creator>Schwartz, Robert S.</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19950301</creationdate><title>Quantification of coronary artery calcium by electron beam computed tomography for determination of severity of angiographic coronary artery disease in younger patients</title><author>Kaufmann, Rachel B. ; Peyser, Patricia A. ; Sheedy, Patrick F. ; Rumberger, John A. ; Schwartz, Robert S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c486t-3325b1f1dd06c83dcc4d91298a1a6af6fbcb42fc87f98a315e9db37b26e541283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Calcinosis - diagnostic imaging</topic><topic>Calcium - analysis</topic><topic>Cardiovascular system</topic><topic>Constriction, Pathologic</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - metabolism</topic><topic>Coronary Disease - pathology</topic><topic>Coronary Vessels - chemistry</topic><topic>Female</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaufmann, Rachel B.</creatorcontrib><creatorcontrib>Peyser, Patricia A.</creatorcontrib><creatorcontrib>Sheedy, Patrick F.</creatorcontrib><creatorcontrib>Rumberger, John A.</creatorcontrib><creatorcontrib>Schwartz, Robert S.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaufmann, Rachel B.</au><au>Peyser, Patricia A.</au><au>Sheedy, Patrick F.</au><au>Rumberger, John A.</au><au>Schwartz, Robert S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quantification of coronary artery calcium by electron beam computed tomography for determination of severity of angiographic coronary artery disease in younger patients</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1995-03-01</date><risdate>1995</risdate><volume>25</volume><issue>3</issue><spage>626</spage><epage>632</epage><pages>626-632</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>This study attempted to 1) evaluate five quantitative measures of coronary artery calcium and determine which best agreed with coronary artery disease severity at angiography; and 2) determine optimal quantity cutpoints to distinguish among no, mild and significant disease.
Coronary artery calcium identified noninvasively by electron beam computed tomography is a sensitive marker for atherosclerosis. Quantitative assessments of calcium could distinguish among patients with no, mild and significant disease in clinical, screening and research settings.
One hundred sixty patients, 23 to 59 years old, underwent coronary angiography and electron beam computed tomography. Coronary artery calciumwas defined as dense (> 130 Hounsfield units) foci ≥2 mm2on the tomogram. Regression and receiver operating characteristic analyses were used to evaluate five quantitative measures of calcium as predictors of the largest stenosis in the coronary arteries and to identify optimal cutpoints for distinguishing among disease categories. No diseasewas defined as no stenosis, mild diseaseas 10% to 49% diameter stenosis in one or more major branches and significant diseaseas ≥ 50% diameter stenosis in one or more major branches.
All measures evaluated performed well. With calcific area as the quantitative measure, the best cutpoint for discriminating between patients with and without disease was the presence of calcium: sensitivity 81%, specificity 86% and overall accuracy 83%. The best cutpoint for discriminating between patients with and without significant disease was 18 mm2: sensitivity 86%, specificity 81% and accuracy 83%.
Because the ranges of calcium quantity overlapped across disease categories, no cutpoints would distinguish among categories with absolute certainty. However, selected cutpoints could rule out disease in most healthy subjects and identify most patients with significant disease.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7860906</pmid><doi>10.1016/0735-1097(94)00435-S</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Biological and medical sciences Calcinosis - diagnostic imaging Calcium - analysis Cardiovascular system Constriction, Pathologic Coronary Angiography Coronary Disease - diagnostic imaging Coronary Disease - metabolism Coronary Disease - pathology Coronary Vessels - chemistry Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Radiodiagnosis. Nmr imagery. Nmr spectrometry ROC Curve Sensitivity and Specificity Tomography, X-Ray Computed |
| title | Quantification of coronary artery calcium by electron beam computed tomography for determination of severity of angiographic coronary artery disease in younger patients |
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