No abstract

Abstract-Electron-beam CT may assess the progression of coronary atherosclerosis by visualizing changes in calcification. The present investigation analyzes (1) the rate of progression of calcification in symptomatic patients, (2) the topographic pattern, and (3) the influence of baseline plaque burden and risk factors. Progression of calcification during a mean (median) interval of 18 (15) months was measured in 102 symptomatic outpatients (aged 59Ϯ9 years, 80% male) with calcification. In 4 patient groups with a baseline total score (Agatston criteria) of 1 to 30, Ͼ30 to 100, Ͼ100 to 400, and Ͼ400, the median was 3.1, 26.1, 58.9, and 109.7, respectively, for absolute annual progression of the score (PϽ0.05) and 57%, 49%, 32%, and 15%, respectively, for relative progression (PϽ0.05). On the coronary segmental level, changes were largely restricted to typical predilection sites of coronary atherosclerosis. The presence of angiographically defined coronary narrowing influenced absolute, but not relative, progression. Of the risk factors, only low density lipoprotein cholesterol levels showed a trend, although not significant, for predicting progression. These data indicate that baseline plaque burden determines the rate of progression of calcification. This appears to be a coronary systemic process, reflecting the natural history of coronary atherosclerosis. Key Words: progression Ⅲ coronary atherosclerosis Ⅲ calcium Ⅲ electron-beam CT Ⅲ coronary artery disease E lectron-beam CT (EBCT) has been used in serial studies to determine the progression of coronary calcified plaque disease. [1][2][3][4][5][6] The natural rate of progression of calcification has been described in healthy subjects in a community setting. 4 It has been suggested that in asymptomatic high-risk patients, the influence of treating elevated lipid levels on the progression of coronary atherosclerotic disease can be evaluated by use of EBCT. 3,5 If these reports are taken into consideration, EBCT may be of value in assessing the treatment of symptomatic patients. However, little is known about the rate of progression to be expected in symptomatic patients with modern pharmacological therapy. The progression of calcification may vary substantially between patients with or without established coronary artery disease (CAD) and may depend on the baseline amount of calcification. 6 As calcification develops, the pattern of distribution among the major coronary arteries and the coronary segments has not been clarified. Only the changes in the overall amount of calcification have previously been reported. It was the aim of the present investigation (1) to analyze the rate of progression of calcification in symptomatic patients with modern treatment, (2) to establish the topographic pattern of progression, and (3) to determine the relationship of EBCT-derived and angiographic coronary findings and of risk factors with the rate of progression. Methods PatientsOutpatients followed in the Cardiology Department of the University Clinic Essen because of known...

Electron-beam CT may be helpful in localizing intracoronary stents and assessing stent patency noninvasively to delay the intervals between catheterizations in an increasing number of patients.

Symptomatic males with extensive CSs carry an even higher risk for future events than other symptomatic males with advanced CAD. In these patients, EBT-based calcified plaque burden and angiographic indices of disease severity may have a complementary role in predicting future cardiovascular events.