Feature | December 26, 2013

Study Shows Value of Calcium Scan in Predicting Heart Attack, Stroke Among Those Considered Low or High Risk

Low or high risk coronary artery calcium testing trumps cholesterol levels, high blood pressure, other risk factors in predicting heart attacks, deaths

December 26, 2013 — A study shows that coronary artery calcium (CAC) screening, an assessment tool that is not currently recommended for people considered at low risk, should play a more prominent role in helping determine a person’s risk for heart attack and heart disease-related death, as well as the need for angioplasty or bypass surgery. CAC screening provides a direct measure of calcium deposits in heart arteries and is easily obtained on a computed tomography (CT) scan.
 
“We showed that by using only the traditional risk factors, we miss a significant percentage of individuals at high risk. We may also be over-treating a large number of people who can safely avoid lifelong treatment,” said lead author Michael Silverman, M.D., cardiology fellow, Brigham and Women’s Hospital, Boston, and lead author. Silverman formerly worked at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore.
 
In the study published online Dec. 23 in the European Heart Journal, the researchers compared two approaches to risk assessment. One approach looked only at risk factors including cholesterol, blood pressure, current smoking and diabetes. The other used the direct measurement of atherosclerosis as seen on the coronary artery calcium score.
 
“Our study, using data from almost 7,000 adult participants in the Multi-Ethnic Study of Atherosclerosis (MESA), shows that coronary artery calcium screening provides an accurate, personalized assessment for those who, by traditional risk factors, are at either high or low risk of a heart attack or death from coronary artery disease,” said Khurram Nasir, M.D., M.P.H, director, wellness and prevention research, Baptist Health Medical Group, Miami, and senior author of the study. Nasir is also an adjunct faculty member at the Johns Hopkins University School of Medicine.
 
The MESA participants did not have evidence of heart disease when they joined the study between 2000 and 2002. They were assessed for risk factors and had a coronary calcium scan and were followed for a mean of 7.1 years for coronary heart disease events, such as heart attacks.
 
“We found that 15 percent of people believed to be at very low risk actually had high coronary artery calcium scores above 100 and were at relatively high risk of a cardiac event over the next seven years,” said Roger Blumenthal, M.D., professor of medicine, director, Johns Hopkins Ciccarone Center, and co-author of the study. “On the other hand, 35 percent of study participants thought to be at very high risk and needing aggressive therapy with aspirin and statin medication actually had no coronary artery calcium and an extremely low event rate of the next seven years. For them, we can emphasize lifestyle modifications.”
 
According to Nasir, the results may encourage a major paradigm shift in how physicians estimate heart disease risk for their patients. 
 
“Our study shows that coronary artery calcium testing holds promise as a frontline assessment for people before they develop heart disease symptoms. In the meantime, we believe that doctors should consider offering a coronary artery calcium scan to their patients to markedly improve risk prediction if they are unsure whether they should be on lifelong statin and aspirin therapy.”
 
The study, “Impact of Coronary Artery Calcium on Coronary Heart Disease Events in Individuals at the Extremes of Traditional Risk Factor Burden: The Multi-Ethnic Study of Atherosclerosis,” was supported by the National Institutes of Health grant numbers N01-HC-95159 to N01-HC-95166, N01 HC 95169, U01HL105270-03 to HMK and T32-HL-7227-36 to MGS.
 
For more information: baptisthealth.com, www.hopkinsmedicine.org, eurheartj.oxfordjournals.org

Related Content

#COVID19 #Coronavirus #2019nCoV #Wuhanvirus #SARScov2 Chest CT findings of pediatric patients with COVID-19 on transaxial images. (a) Male, 2 months old, 2 days after symptom onset. Patchy ground-glass opacities GGO in the right lower lobe

Chest CT findings of pediatric patients with COVID-19 on transaxial images. Male, 2 months old, 2 days after symptom onset. Patchy ground-glass opacities GGO in the right lower lobe. Image courtesy of Radiology: Cardiothoracic Imaging

News | Coronavirus (COVID-19) | April 06, 2020
April 6, 2020 — Children and teenagers with COVID-19...
#COVID19 #Coronavirus #2019nCoV #Wuhanvirus #SARScov2 Sonogram taken under rib cage shows liver (grey) with curved diaphragm-lung border (white). Arrows point to vertical B lines (white) demonstrating diseased lung tissue. The more B lines the worse the disease. Healing is measured by reduction in the number of B lines.

Sonogram taken under rib cage shows liver (grey) with curved diaphragm-lung border (white). Arrows point to vertical B lines (white) demonstrating diseased lung tissue. The more B lines the worse the disease. Healing is measured by reduction in the number of B lines.

News | Coronavirus (COVID-19) | April 06, 2020
April 6, 2020 — Robert L.
#COVID19 #Coronavirus #2019nCoV #Wuhanvirus #SARScov2

Getty Images

Feature | Coronavirus (COVID-19) | April 03, 2020 | By Melinda Taschetta-Millane and Dave Fornell
In an effort to keep the imaging field updated on the latest information being released on coronavirus (COVID-19), th
Recommended best practices for nuclear imaging departments under the COVIF-19 pandemic have been issues by the ASNC and SNMMI. #COVID19 #ASNC #SNMMI #Coronavirus #SARScov2
News | Coronavirus (COVID-19) | April 03, 2020
April 3, 2020 — A new guidance document on best practices to maintain safety and minimize contamination in nuclear im
An example of Philips’ TrueVue technology, which offers photo-realistic rendering and the ability to change the location of the lighting source on 3-D ultrasound images. In this example of two Amplazer transcatheter septal occluder devices in the heart, the operator demonstrating the product was able to push the lighting source behind the devices into the other chamber of the heart. This illuminated a hole that was still present that the occluders did not seal.

An example of Philips’ TrueVue technology, which offers photo-realistic rendering and the ability to change the location of the lighting source on 3-D ultrasound images. In this example of two Amplazer transcatheter septal occluder devices in the heart, the operator demonstrating the product was able to push the lighting source behind the devices into the other chamber of the heart. This illuminated a hole that was still present that the occluders did not seal. Photo by Dave Fornell

Feature | Radiology Imaging | April 02, 2020 | By Katie Caron
A new year — and decade — offers the opportunity to reflect on the advancements and challenges of years gone by and p
#COVID19 #Coronavirus #2019nCoV #Wuhanvirus

Getty Images

Feature | Coronavirus (COVID-19) | April 02, 2020 | Jilan Liu and HIMSS Greater China Team
Information technologies have played a pivotal role in China’s response to the novel coronavirus...
#COVID19 #Coronavirus #2019nCoV #Wuhanvirus #SARScov2 Updated CT scoring criteria from AJR considers both lobe involvement and changes in CT findings to quantitatively and accurately evaluate the progression of COVID-19 pneumonia

CT scoring criteria were applied to images from sequential chest CT examinations. A, Initial chest CT image obtained 2 days after onset of symptoms shows small region of subpleural ground-glass opacities in right lower lobe, for CT score of 1. B, Chest CT image obtained on day 3 of treatment shows slightly enlarged region of subpleural ground-glass opacities with partial crazy-paving pattern and consolidation, for CT score of 3. C, Chest CT image obtained on day 5 of treatment shows partial resolution of consolidation, for CT score of 2. D, Chest CT image obtained on day 14 of treatment shows continued resolution of consolidation with minimal residual ground-glass opacities, for CT score of 1. Image courtesy of American Journal of Roentgenology (AJR)

News | Computed Tomography (CT) | April 02, 2020
April 2, 2020 — Updated computed t...
#COVID19 #Coronavirus #2019nCoV #Wuhanvirus #SARScov2 the company is now offering a suite of AI solutions Vuno Med-LungQuant and Vuno Med-Chest X-ray for COVID-19, encompassing both lung X-ray and computed tomography (CT) modalities respectively all at once
News | Artificial Intelligence | April 02, 2020
April 2, 2020 — In the face of the COVID-19 pand