Skip to main content
Erschienen in: European Radiology 11/2018

03.05.2018 | Cardiac

Coronary artery calcium assessed with calibrated mass scoring in asymptomatic individuals: results from the Copenhagen General Population Study

verfasst von: Andreas D. Knudsen, Andreas Fuchs, J. Tobias Kühl, Ben A. Arnold, Børge G. Nordestgaard, Lars V. Køber, Klaus F. Kofoed

Erschienen in: European Radiology | Ausgabe 11/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Coronary artery calcification (CAC) is commonly assessed with Agatston score (AS). A higher sensitivity and precision for the detection of CAC has been demonstrated with calibrated mass score (cMS). We hypothesized that cMS would detect low-level CAC not detectable with AS in a large asymptomatic background population.

Methods

Participants (N = 2985) from the Copenhagen General Population Study were evaluated for CAC using both conventional AS and cMS. The population was grouped according to number of traditional risk factors and heart score was used to assess the risk of event for those with no CAC, those with only cMS > 0 and those with both AS and cMS > 0.

Results

In participants with an AS = 0, 11% had cMS > 0. The risk profile of this cMS-only group was between that of the CAC-negative participants and those with AS > 0 and cMS > 0. Overall, 6% of the population belonged to the cMS-only group independent of the number of risk factors.

Conclusion

In individuals with AS = 0, a fraction was found to have cMS > 0. Based on traditional risk factors, this group has a higher 10-year risk than individuals with both AS = 0 and cMS = 0; cMS might offer very early cardiovascular risk assessment in asymptomatic individuals.

Key Points

• In individuals with AS=0, a fraction has CAC with highly sensitive cMS.
• This fraction has a higher 10-year risk of cardiovascular disease.
• Regardless of risk factors, 6% has CAC detectable only with cMS.
• cMS might offer very early cardiovascular risk assessment in asymptomatic individuals.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Piepoli MF, Hoes AW, Agewall S et al (2016) 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 37:2315–2381CrossRef Piepoli MF, Hoes AW, Agewall S et al (2016) 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 37:2315–2381CrossRef
2.
Zurück zum Zitat Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ (2003) Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 228:826–833CrossRef Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ (2003) Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 228:826–833CrossRef
3.
Zurück zum Zitat Detrano R, Guerci AD, Carr JJ et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345CrossRef Detrano R, Guerci AD, Carr JJ et al (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345CrossRef
4.
Zurück zum Zitat Yeboah J, RL MC, Polonsky TS et al (2012) Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA 308:788–795CrossRef Yeboah J, RL MC, Polonsky TS et al (2012) Comparison of novel risk markers for improvement in cardiovascular risk assessment in intermediate-risk individuals. JAMA 308:788–795CrossRef
5.
Zurück zum Zitat Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215CrossRef Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215CrossRef
6.
Zurück zum Zitat Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD (2005) Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol 46:158–165CrossRef Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD (2005) Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol 46:158–165CrossRef
7.
Zurück zum Zitat Erbel R, Mohlenkamp S, Moebus S et al (2010) Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall study. J Am Coll Cardiol 56:1397–1406CrossRef Erbel R, Mohlenkamp S, Moebus S et al (2010) Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf Recall study. J Am Coll Cardiol 56:1397–1406CrossRef
8.
Zurück zum Zitat Hecht HS, Narula J (2012) Coronary artery calcium scanning in asymptomatic patients with diabetes mellitus: a paradigm shift. J Diabetes 4:342–350CrossRef Hecht HS, Narula J (2012) Coronary artery calcium scanning in asymptomatic patients with diabetes mellitus: a paradigm shift. J Diabetes 4:342–350CrossRef
9.
Zurück zum Zitat Becker A, Leber A, Becker C, Knez A (2008) Predictive value of coronary calcifications for future cardiac events in asymptomatic individuals. Am Heart J 155:154–160CrossRef Becker A, Leber A, Becker C, Knez A (2008) Predictive value of coronary calcifications for future cardiac events in asymptomatic individuals. Am Heart J 155:154–160CrossRef
10.
Zurück zum Zitat Kavousi M, Elias-Smale S, Rutten JH et al (2012) Evaluation of newer risk markers for coronary heart disease risk classification: a cohort study. Ann Intern Med 156:438–444CrossRef Kavousi M, Elias-Smale S, Rutten JH et al (2012) Evaluation of newer risk markers for coronary heart disease risk classification: a cohort study. Ann Intern Med 156:438–444CrossRef
11.
Zurück zum Zitat Blaha MJ, Cainzos-Achirica M, Greenland P et al (2016) Role of Coronary Artery Calcium Score of Zero and Other Negative Risk Markers for Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 133:849–858CrossRef Blaha MJ, Cainzos-Achirica M, Greenland P et al (2016) Role of Coronary Artery Calcium Score of Zero and Other Negative Risk Markers for Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 133:849–858CrossRef
12.
Zurück zum Zitat Budoff MJ, Shaw LJ, Liu ST et al (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49:1860–1870CrossRef Budoff MJ, Shaw LJ, Liu ST et al (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49:1860–1870CrossRef
13.
Zurück zum Zitat Blaha M, Budoff MJ, Shaw LJ et al (2009) Absence of coronary artery calcification and all-cause mortality. JACC Cardiovasc Imaging 2:692–700CrossRef Blaha M, Budoff MJ, Shaw LJ et al (2009) Absence of coronary artery calcification and all-cause mortality. JACC Cardiovasc Imaging 2:692–700CrossRef
14.
Zurück zum Zitat Hecht HS (2015) Coronary artery calcium scanning: past, present, and future. JACC Cardiovasc Imaging 8:579–596CrossRef Hecht HS (2015) Coronary artery calcium scanning: past, present, and future. JACC Cardiovasc Imaging 8:579–596CrossRef
15.
Zurück zum Zitat Budoff MJ, McClelland RL, Nasir K et al (2009) Cardiovascular events with absent or minimal coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J 158:554–561CrossRef Budoff MJ, McClelland RL, Nasir K et al (2009) Cardiovascular events with absent or minimal coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Am Heart J 158:554–561CrossRef
16.
Zurück zum Zitat Joshi PH, Blaha M, Budoff MJ et al (2014) The Ten Year Prognostic Value of Zero and Minimal Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 130:A11701 Joshi PH, Blaha M, Budoff MJ et al (2014) The Ten Year Prognostic Value of Zero and Minimal Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 130:A11701
17.
Zurück zum Zitat Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832CrossRef Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832CrossRef
18.
Zurück zum Zitat Alluri K, Joshi PH, Henry TS, Blumenthal RS, Nasir K, Blaha MJ (2015) Scoring of coronary artery calcium scans: history, assumptions, current limitations, and future directions. Atherosclerosis 239:109–117CrossRef Alluri K, Joshi PH, Henry TS, Blumenthal RS, Nasir K, Blaha MJ (2015) Scoring of coronary artery calcium scans: history, assumptions, current limitations, and future directions. Atherosclerosis 239:109–117CrossRef
19.
Zurück zum Zitat Lu B, Budoff MJ, Zhuang N et al (2002) Causes of interscan variability of coronary artery calcium measurements at electron-beam CT. Acad Radiol 9:654–661CrossRef Lu B, Budoff MJ, Zhuang N et al (2002) Causes of interscan variability of coronary artery calcium measurements at electron-beam CT. Acad Radiol 9:654–661CrossRef
20.
Zurück zum Zitat Hong C, Bae KT, Pilgram TK (2003) Coronary artery calcium: accuracy and reproducibility of measurements with multi-detector row CT--assessment of effects of different thresholds and quantification methods. Radiology 227:795–801CrossRef Hong C, Bae KT, Pilgram TK (2003) Coronary artery calcium: accuracy and reproducibility of measurements with multi-detector row CT--assessment of effects of different thresholds and quantification methods. Radiology 227:795–801CrossRef
21.
Zurück zum Zitat Hoffmann U, Siebert U, Bull-Stewart A et al (2006) Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort--consequences for progression studies. Eur J Radiol 57:396–402CrossRef Hoffmann U, Siebert U, Bull-Stewart A et al (2006) Evidence for lower variability of coronary artery calcium mineral mass measurements by multi-detector computed tomography in a community-based cohort--consequences for progression studies. Eur J Radiol 57:396–402CrossRef
22.
Zurück zum Zitat Arnold BA, Xiang P, Budoff MJ, Mao SS (2012) Very small calcifications are detected and scored in the coronary arteries from small voxel MDCT images using a new automated/calibrated scoring method with statistical and patient specific plaque definitions. Int J Card Imaging 28:1193–1204CrossRef Arnold BA, Xiang P, Budoff MJ, Mao SS (2012) Very small calcifications are detected and scored in the coronary arteries from small voxel MDCT images using a new automated/calibrated scoring method with statistical and patient specific plaque definitions. Int J Card Imaging 28:1193–1204CrossRef
23.
Zurück zum Zitat Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A (2007) Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA 298:299–308CrossRef Nordestgaard BG, Benn M, Schnohr P, Tybjaerg-Hansen A (2007) Nonfasting triglycerides and risk of myocardial infarction, ischemic heart disease, and death in men and women. JAMA 298:299–308CrossRef
24.
Zurück zum Zitat Hindso L, Fuchs A, Kuhl JT et al (2017) Normal values of regional left ventricular myocardial thickness, mass and distribution-assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study. Int J Card Imaging 33:421–429CrossRef Hindso L, Fuchs A, Kuhl JT et al (2017) Normal values of regional left ventricular myocardial thickness, mass and distribution-assessed by 320-detector computed tomography angiography in the Copenhagen General Population Study. Int J Card Imaging 33:421–429CrossRef
25.
Zurück zum Zitat Conroy RM, Pyorala K, Fitzgerald AP et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003CrossRef Conroy RM, Pyorala K, Fitzgerald AP et al (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24:987–1003CrossRef
26.
Zurück zum Zitat Fuchs A, Groen JM, Arnold BA et al (2017) Assessment of coronary calcification using calibrated mass score with two different multidetector computed tomography scanners in the Copenhagen General Population Study. Eur J Radiol 88:21–25CrossRef Fuchs A, Groen JM, Arnold BA et al (2017) Assessment of coronary calcification using calibrated mass score with two different multidetector computed tomography scanners in the Copenhagen General Population Study. Eur J Radiol 88:21–25CrossRef
27.
Zurück zum Zitat Nakazato R, Dey D, Gutstein A et al (2009) Coronary artery calcium scoring using a reduced tube voltage and radiation dose protocol with dual-source computed tomography. J Cardiovasc Comput Tomogr 3:394–400CrossRef Nakazato R, Dey D, Gutstein A et al (2009) Coronary artery calcium scoring using a reduced tube voltage and radiation dose protocol with dual-source computed tomography. J Cardiovasc Comput Tomogr 3:394–400CrossRef
28.
Zurück zum Zitat Arnold BA, Xiang P, Mao SS, Budoff MJ (2010) Peak SNR in automated coronary calcium scoring: selecting CT scan parameters and statistically defined scoring thresholds. Med Phys 37:3621–3632CrossRef Arnold BA, Xiang P, Mao SS, Budoff MJ (2010) Peak SNR in automated coronary calcium scoring: selecting CT scan parameters and statistically defined scoring thresholds. Med Phys 37:3621–3632CrossRef
29.
Zurück zum Zitat Lakoski SG, Greenland P, Wong ND et al (2007) Coronary artery calcium scores and risk for cardiovascular events in women classified as "low risk" based on Framingham risk score: the multi-ethnic study of atherosclerosis (MESA). Arch Intern Med 167:2437–2442CrossRef Lakoski SG, Greenland P, Wong ND et al (2007) Coronary artery calcium scores and risk for cardiovascular events in women classified as "low risk" based on Framingham risk score: the multi-ethnic study of atherosclerosis (MESA). Arch Intern Med 167:2437–2442CrossRef
30.
Zurück zum Zitat Cheng VY, Lepor NE, Madyoon H, Eshaghian S, Naraghi AL, Shah PK (2007) Presence and severity of noncalcified coronary plaque on 64-slice computed tomographic coronary angiography in patients with zero and low coronary artery calcium. Am J Cardiol 99:1183–1186CrossRef Cheng VY, Lepor NE, Madyoon H, Eshaghian S, Naraghi AL, Shah PK (2007) Presence and severity of noncalcified coronary plaque on 64-slice computed tomographic coronary angiography in patients with zero and low coronary artery calcium. Am J Cardiol 99:1183–1186CrossRef
Metadaten
Titel
Coronary artery calcium assessed with calibrated mass scoring in asymptomatic individuals: results from the Copenhagen General Population Study
verfasst von
Andreas D. Knudsen
Andreas Fuchs
J. Tobias Kühl
Ben A. Arnold
Børge G. Nordestgaard
Lars V. Køber
Klaus F. Kofoed
Publikationsdatum
03.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 11/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5446-7

Weitere Artikel der Ausgabe 11/2018

European Radiology 11/2018 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.