NEW YORK (Reuters Health), Jan 15 - The determination of coronary calcifications may help identify asymptomatic patients at risk for future MI or cardiac death, according to findings published in the January issue of the American Heart Journal.
Dr. Alexander Becker and colleagues from Ludwig-Maximilians-University, Munich, Germany, examined the predictive value of coronary calcifications for future cardiovascular events in 1,726 asymptomatic individuals (1,018 men and 708 women, mean age 57.7 years) referred for a cardiologic examination.
The team used electron beam computed tomography to determine coronary calcifications, and calculated the Agatston score for quantification of coronary calcifications. The event rate for cardiac death and MI was recorded over a mean observation period of 40.3 months.
Coronary calcifications could be excluded in 379 subjects. A total of 724 patients showed an Agatston score above the 75th percentile.
Cardiac death occurred in 66 patients (0.9% annualized rate) and 114 patients had an MI (1.6% annualized rate).
No cardiac events were observed in patients with exclusion of coronary calcifications.
An Agatston score above the 75th percentile was associated with significantly higher annualized rates for all events, coronary revascularization, MI, and cardiac death.
The investigators also compared the results with risk models based on conventional risk factor stratification: the 10-year risk of coronary events calculated according to the Adult Treatment Panel III (ATP III risk), the PROCAM study, and the ESC score project.
Dr. Becker's team found that "the Agatston score showed a higher diagnostic accuracy in predicting MI compared with ATP III risk score and PROCAM score."
Last Updated: 2008-01-14 17:58:11 -0400 (Reuters Health)
Am Heart J 2008;155:154-160.
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