Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: Comparison with electrocardiographic and thallium exercise stress test results
This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests. Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1995-11, Vol.26 (5), p.1209-1221 |
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| creator | Kajinami, Kouji Seki, Hiroyasu Takekoshi, Noboru Mabuchi, Hiroshi |
| description | This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests.
Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established.
Using the volume mode of electron beam computed tomography, we studied 251 consecutive patients who underwent elective coronary angiography because of suspected coronary artery disease and compared the results with those of ECG and thallium exercise tests. The total coronary calcification score was calculated by multiplying the area (≥2 pixels) of calcification (peak density ≥ 130 Hounsfield units) by an arbitrarily weighted density score (0 to 4) based on its peak density. The mean of two scans was log transformed.
Calcification was first noted in women in the 4th decade of life, ∼ 10 years later than its occurrence in men. Among patients with advanced atherosclerosis (two- and three-vessel disease), calcification scores were uniformly high in women but ranged widely in men. Nine percent of patients with significant stenoses (≥75% by densitometry) had no calcification. The calcification scores of patients with significant stenosis in at least one vessel were significantly higher than those of patients without significant stenosis in the study group as a whole and in most patient subgroups classified according to age and gender. A cutoff calcification score for prediction of significant stenosis, determined by receiver operating characteristic curve analysis, showed high sensitivity (0.77) and specificity (0.86) in all study patients; sensitivity was similarly high even in older patients (≥70 years) and was enhanced in middle-aged patients (40 to ≤60 years). The difference in specificity between calcification scores and ECG exercise test results had borderline significance (p = 0.058) and that between calcification scores and thallium test results was significant (p = 0.001). The latter difference became small but remained significant (p = 0.01) even after the reevaluation of thallium test results in light of each subject's clinical data.
Quantification of coronary artery calcification with electron beam computed tomography noninvasively predicted angiographically confirmed coronary stenosis. Results obtained with this method were at least as useful and potentially better in some patient groups than those obtained with thallium and ECG exercis |
| doi_str_mv | 10.1016/0735-1097(95)00314-2 |
| format | Article |
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Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established.
Using the volume mode of electron beam computed tomography, we studied 251 consecutive patients who underwent elective coronary angiography because of suspected coronary artery disease and compared the results with those of ECG and thallium exercise tests. The total coronary calcification score was calculated by multiplying the area (≥2 pixels) of calcification (peak density ≥ 130 Hounsfield units) by an arbitrarily weighted density score (0 to 4) based on its peak density. The mean of two scans was log transformed.
Calcification was first noted in women in the 4th decade of life, ∼ 10 years later than its occurrence in men. Among patients with advanced atherosclerosis (two- and three-vessel disease), calcification scores were uniformly high in women but ranged widely in men. Nine percent of patients with significant stenoses (≥75% by densitometry) had no calcification. The calcification scores of patients with significant stenosis in at least one vessel were significantly higher than those of patients without significant stenosis in the study group as a whole and in most patient subgroups classified according to age and gender. A cutoff calcification score for prediction of significant stenosis, determined by receiver operating characteristic curve analysis, showed high sensitivity (0.77) and specificity (0.86) in all study patients; sensitivity was similarly high even in older patients (≥70 years) and was enhanced in middle-aged patients (40 to ≤60 years). The difference in specificity between calcification scores and ECG exercise test results had borderline significance (p = 0.058) and that between calcification scores and thallium test results was significant (p = 0.001). The latter difference became small but remained significant (p = 0.01) even after the reevaluation of thallium test results in light of each subject's clinical data.
Quantification of coronary artery calcification with electron beam computed tomography noninvasively predicted angiographically confirmed coronary stenosis. Results obtained with this method were at least as useful and potentially better in some patient groups than those obtained with thallium and ECG exercise testing.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(95)00314-2</identifier><identifier>PMID: 7594034</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Calcinosis - diagnosis ; Calcinosis - physiopathology ; Cardiovascular system ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Electrocardiography ; Exercise Test ; Female ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Risk Factors ; Sex Factors ; Thallium Radioisotopes ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed - methods</subject><ispartof>Journal of the American College of Cardiology, 1995-11, Vol.26 (5), p.1209-1221</ispartof><rights>1995 American College of Cardiology</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-4ce252c36c4dd357f57bef63746c5f2fca00fefa5c57d0955b11e057751757cf3</citedby><cites>FETCH-LOGICAL-c421t-4ce252c36c4dd357f57bef63746c5f2fca00fefa5c57d0955b11e057751757cf3</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(95)00314-2$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2894276$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7594034$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kajinami, Kouji</creatorcontrib><creatorcontrib>Seki, Hiroyasu</creatorcontrib><creatorcontrib>Takekoshi, Noboru</creatorcontrib><creatorcontrib>Mabuchi, Hiroshi</creatorcontrib><title>Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: Comparison with electrocardiographic and thallium exercise stress test results</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests.
Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established.
Using the volume mode of electron beam computed tomography, we studied 251 consecutive patients who underwent elective coronary angiography because of suspected coronary artery disease and compared the results with those of ECG and thallium exercise tests. The total coronary calcification score was calculated by multiplying the area (≥2 pixels) of calcification (peak density ≥ 130 Hounsfield units) by an arbitrarily weighted density score (0 to 4) based on its peak density. The mean of two scans was log transformed.
Calcification was first noted in women in the 4th decade of life, ∼ 10 years later than its occurrence in men. Among patients with advanced atherosclerosis (two- and three-vessel disease), calcification scores were uniformly high in women but ranged widely in men. Nine percent of patients with significant stenoses (≥75% by densitometry) had no calcification. The calcification scores of patients with significant stenosis in at least one vessel were significantly higher than those of patients without significant stenosis in the study group as a whole and in most patient subgroups classified according to age and gender. A cutoff calcification score for prediction of significant stenosis, determined by receiver operating characteristic curve analysis, showed high sensitivity (0.77) and specificity (0.86) in all study patients; sensitivity was similarly high even in older patients (≥70 years) and was enhanced in middle-aged patients (40 to ≤60 years). The difference in specificity between calcification scores and ECG exercise test results had borderline significance (p = 0.058) and that between calcification scores and thallium test results was significant (p = 0.001). The latter difference became small but remained significant (p = 0.01) even after the reevaluation of thallium test results in light of each subject's clinical data.
Quantification of coronary artery calcification with electron beam computed tomography noninvasively predicted angiographically confirmed coronary stenosis. Results obtained with this method were at least as useful and potentially better in some patient groups than those obtained with thallium and ECG exercise testing.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Calcinosis - diagnosis</subject><subject>Calcinosis - physiopathology</subject><subject>Cardiovascular system</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Electrocardiography</subject><subject>Exercise Test</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>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Thallium Radioisotopes</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Tomography, X-Ray Computed - methods</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>eNp9kc-O0zAQxi0EWsrCG4DkA0JwCNiJHTd7QEIV_6QVXOBsOZPx1iixs7ZT6MPyLri0lAMSF4818_tGo-8j5DFnLznj7SumGllx1qnnnXzBWMNFVd8hKy7lumpkp-6S1Rm5Tx6k9I0x1q55d0EulOwEa8SK_PwUvPM7k9wO6RxxcJBd8DRYCiEGb-KemrzFGBKMh9cl2u_p7WJ8dtaB-ZeOGUsBM8JfYEnO31AcEXLBaI9mKoppXjIONIcp3EQzb_dXdFOaJrpUoO8ub_9IwMTBHSEH1Pgi2ppxdMtE8QdGcAlpyhFTohlTpuW3jDk9JPesGRM-OtVL8vXd2y-bD9X15_cfN2-uKxA1z5UArGUNTQtiGBqprFQ92rZRogVpawuGMYvWSJBqYJ2UPefIpFKSK6nANpfk2XHvHMPtUg7Qk0uA42g8hiXpQqp1I0UBxRGEYmWKaPUc3VRs05zpQ6r6EJk-RKY7qX-nqusie3Lav_QTDmfRKcYyf3qam1SMt9H4YskZq9edqFVbsNdHDIsXO4dRJ3DooaQei816CO7_d_wC1GLHEQ</recordid><startdate>19951101</startdate><enddate>19951101</enddate><creator>Kajinami, Kouji</creator><creator>Seki, Hiroyasu</creator><creator>Takekoshi, Noboru</creator><creator>Mabuchi, Hiroshi</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>19951101</creationdate><title>Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: Comparison with electrocardiographic and thallium exercise stress test results</title><author>Kajinami, Kouji ; Seki, Hiroyasu ; Takekoshi, Noboru ; Mabuchi, Hiroshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-4ce252c36c4dd357f57bef63746c5f2fca00fefa5c57d0955b11e057751757cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Calcinosis - diagnosis</topic><topic>Calcinosis - physiopathology</topic><topic>Cardiovascular system</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Electrocardiography</topic><topic>Exercise Test</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>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Thallium Radioisotopes</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Tomography, X-Ray Computed - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kajinami, Kouji</creatorcontrib><creatorcontrib>Seki, Hiroyasu</creatorcontrib><creatorcontrib>Takekoshi, Noboru</creatorcontrib><creatorcontrib>Mabuchi, Hiroshi</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>Kajinami, Kouji</au><au>Seki, Hiroyasu</au><au>Takekoshi, Noboru</au><au>Mabuchi, Hiroshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: Comparison with electrocardiographic and thallium exercise stress test results</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1995-11-01</date><risdate>1995</risdate><volume>26</volume><issue>5</issue><spage>1209</spage><epage>1221</epage><pages>1209-1221</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests.
Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established.
Using the volume mode of electron beam computed tomography, we studied 251 consecutive patients who underwent elective coronary angiography because of suspected coronary artery disease and compared the results with those of ECG and thallium exercise tests. The total coronary calcification score was calculated by multiplying the area (≥2 pixels) of calcification (peak density ≥ 130 Hounsfield units) by an arbitrarily weighted density score (0 to 4) based on its peak density. The mean of two scans was log transformed.
Calcification was first noted in women in the 4th decade of life, ∼ 10 years later than its occurrence in men. Among patients with advanced atherosclerosis (two- and three-vessel disease), calcification scores were uniformly high in women but ranged widely in men. Nine percent of patients with significant stenoses (≥75% by densitometry) had no calcification. The calcification scores of patients with significant stenosis in at least one vessel were significantly higher than those of patients without significant stenosis in the study group as a whole and in most patient subgroups classified according to age and gender. A cutoff calcification score for prediction of significant stenosis, determined by receiver operating characteristic curve analysis, showed high sensitivity (0.77) and specificity (0.86) in all study patients; sensitivity was similarly high even in older patients (≥70 years) and was enhanced in middle-aged patients (40 to ≤60 years). The difference in specificity between calcification scores and ECG exercise test results had borderline significance (p = 0.058) and that between calcification scores and thallium test results was significant (p = 0.001). The latter difference became small but remained significant (p = 0.01) even after the reevaluation of thallium test results in light of each subject's clinical data.
Quantification of coronary artery calcification with electron beam computed tomography noninvasively predicted angiographically confirmed coronary stenosis. Results obtained with this method were at least as useful and potentially better in some patient groups than those obtained with thallium and ECG exercise testing.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7594034</pmid><doi>10.1016/0735-1097(95)00314-2</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Factors Aged Aged, 80 and over Biological and medical sciences Calcinosis - diagnosis Calcinosis - physiopathology Cardiovascular system Coronary Artery Disease - diagnosis Coronary Artery Disease - physiopathology Electrocardiography Exercise Test Female Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Predictive Value of Tests Prospective Studies Radiodiagnosis. Nmr imagery. Nmr spectrometry Risk Factors Sex Factors Thallium Radioisotopes Tomography, Emission-Computed, Single-Photon Tomography, X-Ray Computed - methods |
| title | Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: Comparison with electrocardiographic and thallium exercise stress test results |
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