Detection of Subclinical Cardiovascular Disease: The Emerging Role of Electron Beam Computed Tomography
Preventive MedicinePublished 1 January 2002
Stuart Rich, Vallerie V. McLaughlin
Citations39
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SJR score1.79
SNIP1.34
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TL;DR
EBCT coronary artery screening may prove to be a valuable adjunct to the traditional methods for the detection of subclinical coronary artery disease and to identify those who would benefit from focused preventive therapies.
Abstract
EBCT coronary artery screening may prove to be a valuable adjunct to the traditional methods for the detection of subclinical coronary artery disease and to identify those who would benefit from focused preventive therapies.
Keywords
MedicineEngineering
NatureThe pathogenesis of atherosclerosis: a perspective for the 1990s
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A simple coronary disease prediction algorithm was developed using categorical variables, which allows physicians to predict multivariate CHD risk in patients without overt CHD.
Journal of the American College of CardiologyQuantification of coronary artery calcium using ultrafast computed tomography
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The DBP results suggest that for the large majority of individuals, whether conventionally "hypertensive" or "normotensive", a lower blood pressure should eventually confer a lower risk of vascular disease.
New England Journal of MedicineAssociation between Multiple Cardiovascular Risk Factors and Atherosclerosis in Children and Young Adults
3,991 Citations1998Gerald S. Berenson, Sathanur R. Srinivasan +4 more
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New England Journal of MedicineCompensatory Enlargement of Human Atherosclerotic Coronary Arteries
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It is concluded that human coronary arteries enlarge in relation to plaque area and that functionally important lumen stenosis may be delayed until the lesion occupies 40 percent of the internal elastic lamina area.
PREVENTION OF CORONARY HEART DISEASE WITH PRAVASTATIN IN MEN WITH HYPERCHOLESTEROLEMIA
3,460 Citations1995J Ames S Hepherd, S Tuart M. C Obbe +7 more
CirculationCan coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease?
1,471 Citations1988William C. Little, M Constantinescu +5 more
Assessment of the angiographic severity of coronary stenosis may be inadequate to accurately predict the time or location of a subsequent coronary occlusion that will produce a myocardial infarction.
CirculationCoronary Artery Calcium Area by Electron-Beam Computed Tomography and Coronary Atherosclerotic Plaque Area
1,457 Citations1995John A. Rumberger, D.Brent Simons +3 more
This histopathologic study confirms an intimate relation between whole heart, coronary artery, and segmental coronary atherosclerotic plaque area and EBCT coronary calcium area but suggests that there is a threshold value for plaque area below which coronary calcium is either absent or not detectable by this methodology.
Journal of the American College of CardiologyAngiographic progression of coronary artery disease and the development of myocardial infarction
1,453 Citations1988John A. Ambrose, Mark Tannenbaum +7 more
It is suggested that myocardial infarction frequently develops from previously nonsevere lesions, and proximal lesion location is the only significant predictor of evolution of lesions greater than or equal to 50% to infarctions.
JAMAIs Relationship Between Serum Cholesterol and Risk of Premature Death From Coronary Heart Disease Continuous and Graded?
1,297 Citations1986Jeremiah Stamler
The data of high precision show that the relationship between serum cholesterol and CHD is not a threshold one, with increased risk confined to the two highest quintiles, but rather is a continuously graded one that powerfully affects risk for the great majority of middle-aged American men.
The American Journal of CardiologyA general cardiovascular risk profile: The Framingham study
1,175 Citations1976William B. Kannel, Daniel McGee +1 more
The function provides an economic and efficient method of identifying persons at high cardiovascular risk who need preventive treatment and persons at low risk whoneed not be alarmed about one moderately elevated risk characteristic.
CellOsteonectin, a bone-specific protein linking mineral to collagen
1,164 Citations1981John D. Termine, Hynda K. Kleinman +4 more
It is suggested that osteonectin is a tissue-specific protein, linking the bone mineral and collagen phases, perhaps initiating active mineralization in normal skeletal tissue.
Arteriosclerosis and Thrombosis A Journal of Vascular BiologyUltrasonographically assessed carotid morphology and the risk of coronary heart disease.
917 Citations1991Jukka T. Salonen, Riitta Salonen
The association of the high-resolution ultrasound assessment of extracranial carotid morphology with the risk of acute coronary events in 1,288 eastern Finnish men was associated with a 3.29-fold (95% confidence interval, 1.31-8.29) risk of severe myocardial infarction compared with men free of any structural changes in the carOTid artery wall at baseline.
CirculationLewis A. Conner Memorial Lecture. Mechanisms leading to myocardial infarction: insights from studies of vascular biology.
855 Citations1994Valentı́n Fuster
The recent past has been very fruitful in yielding a better understanding of the processes leading to myocardial infarction, and the near future appears very promising in terms of preventing the number 1 killer in the western world.
CirculationIdentification of Patients at Increased Risk of First Unheralded Acute Myocardial Infarction by Electron-Beam Computed Tomography
839 Citations2000Paolo Raggi, Tracy Q. Callister +6 more
Coronary calcium is present in most patients who suffer acute coronary events, but although the event rate is greater for patients with high absolute CSs, few patients have this degree of calcification on a screening EBCT, and CS percentiles constitute a more effective screening method to stratify individuals at risk.
RadiologyCoronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method.
744 Citations1998Tracy Q. Callister, Bruce Cooil +4 more
The volumetric score showed better reproducibility than the traditional score, and its variability was considerably less than the score increase in untreated patients after 1 year.
PubMedEvolution and progression of atherosclerotic lesions in coronary arteries of children and young adults.
732 Citations1989Herbert C. Stary
In an autopsy study of the evolution of atherosclerotic lesions in young people, the coronary arteries and aortas of 1160 male and female subjects who died between full-term birth and age 29 years are obtained.
Annals of Internal MedicineLeft Ventricular Mass and Incidence of Coronary Heart Disease in an Elderly Cohort
715 Citations1989Daniel Levy, Robert J. Garrison +3 more
Echocardiographic assessment of left ventricular mass offers prognostic information beyond that provided by traditional risk factors, which can improve the ability to identify individuals at high risk for coronary heart disease.
CirculationIntravascular ultrasound assessment of lumen size and wall morphology in normal subjects and patients with coronary artery disease.
666 Citations1991S.E. Nissen, John C. Gurley +6 more
These data establish that intravascular ultrasound is feasible and safe and yields luminal measurements that correlate generally with angiography, and differences between angiographic and ultrasonic measures of lumen size in eccentric vessels probably reflect the dissimilar perspectives of tomographic and silhouette imaging techniques.
Annals of Internal MedicineElectrocardiographic Left Ventricular Hypertrophy and Risk of Coronary Heart Disease
643 Citations1970William B. Kannel, TAVIA GORDON +2 more
Annals of Internal MedicineCoronary Artery Narrowing in Coronary Heart Disease: Comparison of Cineangiographic and Necropsy Findings
629 Citations1979Ernest N. Arnett, JEFFREY M. ISNER +5 more
The coronary atherosclerotic plaquing was diffuse (greater than 25% cross-sectional area narrowing) in 90% of 467 five-millimetre segments of coronary artery examined, and this diffuseness of the atheosclerotic process seems to be the major reason for angiographic underestimation of coronary narrowings.
Journal of Clinical InvestigationHigh expression of genes for calcification-regulating proteins in human atherosclerotic plaques.
610 Citations1994Catherine M. Shanahan, N. Cary +2 more
The postulated function of OP and MGP as regulators of calcification in bone and the high levels and colocalization of both in atheromatous plaques suggest they have an important role in plaque pathogenesis and stability.
JAMACoronary Artery Disease in Combat Casualties in Vietnam
606 Citations1971John McNamara
Postmortem coronary angiography and dissection of hearts from 105 United States soldiers killed in Vietnam demonstrate that 45% have some evidence of atherosclerosis.
Journal of the American College of CardiologyAtherosclerosis in angiographically “normal” coronary artery reference segments: An intravascular ultrasound study with clinical correlations
587 Citations1995Gary S. Mintz, Jack A. Painter +8 more
Atherosclerosis is ubiquitous in angiographically normal coronary artery reference segments and should be enhanced in the study of risk factors for atherosclerosis and the results of therapies to control disease progression by intravascular ultrasound.
CirculationLong-term survival of medically treated patients in the Coronary Artery Surgery Study (CASS) Registry.
556 Citations1994Mary J. Emond, Michael B. Mock +7 more
High myocardial jeopardy, high anginal class, and two or three proximal diseased vessels characterize the profile of patients most likely to have received surgical treatment during follow-up.
CirculationContribution of localized calcium deposits to dissection after angioplasty. An observational study using intravascular ultrasound.
539 Citations1992Peter J. Fitzgerald, Thomas A. Ports +1 more
The presence of calcium within the vessel wall appeared to be significantly associated with both the location and size of the dissected tissue arm from the vessels wall, suggesting that localized calcium deposits have a direct role in promoting dissection, presumably by increasing shear stresses within the plaque.
CirculationPredictive Value of Electron Beam Computed Tomography of the Coronary Arteries
522 Citations1996Yadon Arad, Louise A. Spadaro +5 more
Coronary EBCT predicts future atherosclerotic cardiovascular disease events in asymptomatic subjects and has sensitivities and specificities that correlate with the severity of underlying coronary artery disease.
The American Journal of CardiologyRelation of the site of acute myocardial infarction to the most severe coronary arterial stenosis at prior angiography
497 Citations1992Didier Giroud, Jian M. Li +3 more
In a selected, medically treated cohort, AMI is frequently related to a segment that was not the most stenotic one or was not even significantly stenosed at previous angiography, particularly with a long interval between the first angiogram and AMI.
CirculationUltrafast Computed Tomography as a Diagnostic Modality in the Detection of Coronary Artery Disease
493 Citations1996Matthew J. Budoff, Demetrios Georgiou +10 more
The presence of calcifications in multiple vessels and in younger populations correlates with higher specificities for obstructive disease, making ultrafast CT coronary scanning a very useful diagnostic test.
Journal of the American College of CardiologySeven year survival of patients with normal or near normal coronary arteriograms: A CASS registry study
466 Citations1986Harvey G. Kemp, Richard A. Kronmal +2 more
Nine risk variables recorded at entry, including age, sex, height, weight, history of smoking, presence of absence of mild disease, electrocardiographic response to exercise, family history of coronary heart disease and a history of hypertension had predictive value for survival.
Journal of the American College of CardiologyAngiographic evolution of coronary artery morphology in unstable angina
461 Citations1986John A. Ambrose, Stephen L. Winters +5 more
The eccentric lesion was seen in 71% of all lesions with progression to less than 100% occlusion in Group I, but it was not seen in any Group II vessel with progression.
CirculationTen-year follow-up of survival and myocardial infarction in the randomized Coronary Artery Surgery Study.
452 Citations1990Edwin L. Alderman, Martial G. Bourassa +7 more
10-year follow-up results confirm earlier reports that patients with left ventricular dysfunction exhibit long-term benefit from an initial strategy of surgical treatment, and have survival equivalent to those patients randomized to initial surgery.
Journal of the American College of CardiologyPrognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography
436 Citations1996Robert Detrano, Tzung K. Hsiai +9 more
Electron beam computed tomographic calcium scores correlate moderately well with angiographic findings and predict coronary heart disease-related events in patients undergoing angiography as well as do the number of angiographically affected arteries.
The American Journal of CardiologyCoronary artery calcium evaluation by electron beam computed tomography and its relation to new cardiovascular events
417 Citations2000Nathan D. Wong, Jeffrey Hsu +4 more
The presence of CAC and increasing score quartiles were related to the occurrence of new myocardial infarction, revascularizations, and total cardiovascular events, and data support previous reports showing CAC to be a modest predictor of future cardiovascular events.
European Heart JournalThe sequence of cell and matrix changes in atherosclerotic lesions of coronary arteries in the first forty years of life
406 Citations1990Herbert C. Stary
When atherosclerotic lesions of any type were present in coronary arteries, the amount of lipid and accompanying cell reactions were greatest in eccentric Thickening; intermediate lesions and atheroma were present only in eccentric thickening while fibroatheroma often extended beyond eccentric thickens.
CirculationCorrelation of the Antemortem Coronary Arteriogram and the Postmortem Specimen
395 Citations1973Zeev Vlodaver, Robert S. Frech +2 more
Of the 134 segments of coronary arteries available for both studies, 44 (33%) were given false-negative arteriographic diagnosis of obstructive atherosclerosis.
Journal of the American College of CardiologySudden death: Lessons from subsets in population studies
381 Citations1985William B. Kannel, Arthur Schatzkin
The key to the prevention of sudden death in the general population is to prevent coronary attacks by avoidance or correction of the aforementioned risk factors.
Surgical Clinics of North AmericaCine Coronary Arteriography
369 Citations1971William C. Sheldon
Coronary arteriography provided the basis for rational selection of patients for surgical treatment of coronary atherosclerosis, as well as for evaluation of the effectiveness of such procedures.
CirculationSeverity of Coronary Artery Calcification by Electron Beam Computed Tomography Predicts Silent Myocardial Ischemia
362 Citations2000Zuo‐Xiang He, Thomas D. Hedrick +5 more
The results support the role of EBCT as the initial screening tool for identifying individuals at various stages of CAD development for whom therapeutic decision making may differ considerably.
RadiologyCoronary artery calcification: assessment with electron beam CT and histomorphometric correlation.
354 Citations1994Gisela C. Mautner, Susanne L. Mautner +5 more
The amount of calcific deposits detected with electron beam CT correlates highly with histomorphometric measurements and correlates well with the degree of coronary artery stenosis, suggesting Electron beam CT is a promising noninvasive technique that can help depict the presence and extent of atherosclerotic plaques.
CirculationDiscrepancies Between Cineangiographic and Postmortem Findings in Patients with Coronary Artery Disease and Recent Myocardial Revascularization
341 Citations1974Claude M. Grondin, Ihor Dyrda +4 more
In 28 consecutive patients who died following coronary artery grafting and within 30 days of a previous coronary cineangiogram, a study was undertaken to compare the findings at autopsy and those at angiography, and most discrepancies occurred in the left coronary artery system.
Arteriosclerosis and Thrombosis A Journal of Vascular BiologyOsteopontin is synthesized by macrophage, smooth muscle, and endothelial cells in primary and restenotic human coronary atherosclerotic plaques.
320 Citations1994Edward R. O’Brien, Michael R. Garvin +5 more
Using in situ hybridization and immunohistochemical methods, it is demonstrated that in addition to macrophages, smooth muscle and endothelial cells synthesize OPN mRNA and protein in human coronary atherosclerotic plaque specimens obtained by directional atherectomy, suggesting that OPN may contribute to cellular accumulations and dystrophic calcification in atherosclerosis plaques.
CirculationSubclinical Disease as an Independent Risk Factor for Cardiovascular Disease
319 Citations1995Lewis H. Kuller, Lynn Shemanski +8 more
The measurement of subclinical disease provides an approach for identifying high-risk older individuals who may be candidates for more active intervention to prevent clinical disease.
Journal of the American College of CardiologyComparison of Electron Beam Computed Tomography With Intracoronary Ultrasound and Coronary Angiography for Detection of Coronary Atherosclerosis
297 Citations1997Dietrich Baumgart, Axel Schmermund +9 more
EBCT is a noninvasive method that helps to visualize the atherosclerotic process by localization and quantification of coronary artery calcifications and detects calcified plaques with high accuracy.
The American Journal of CardiologyPrognostic value of coronary electron-beam computed tomography for coronary heart disease events in asymptomatic populations11The views contained herein represent the private views of the authors and should not be construed in any way to represent those of the Department of Defense or the Department of the Army.
297 Citations2000Patrick G. O’Malley, Allen J. Taylor +3 more
Although EBCT appears to predict combined and hard coronary outcomes similarly in high risk, asymptomatic populations, these results should be interpreted with caution.
RadiologyCoronary artery calcification detected with ultrafast CT as an indication of coronary artery disease.
274 Citations1992Jerome F. Breen, Patrick F. Sheedy +5 more
Ultrafast CT may be beneficial in the screening of selected populations for the presence of atherosclerotic coronary disease and in the detection of patients with angiographically detectable disease.
Journal of the American Medical AssociationPATHOGENESIS OF CORONARY DISEASE IN AMERICAN SOLDIERS KILLED IN KOREA
269 Citations1955William F. Enos
All available clinical data concerning the cases studied are presented and the histopathology of the lesions indicated that the hemodynamics of the coronary circulation, as modified by the variations ofThe coronary arterial tree, is one of the factors in coronary disease.
RadiologyThe diagnostic and prognostic significance of coronary artery calcification. A report of 800 cases.
265 Citations1980James R. Margolis, J T Chen +4 more
The prognostic significance of coronary artery calcification appears to be independent of information obtained by cardiac catheterization and angiocardiography.
CirculationCoronary Calcium, as Determined by Electron Beam Computed Tomography, and Coronary Disease on Arteriogram
243 Citations1995John A. Rumberger, Patrick F. Sheedy +2 more
In a middle-aged population, noninvasive definition of coronary calcium by EBCT has similar predictive value for arteriographic coronary artery disease in men and women.
The American Journal of CardiologySignificance of calcification of the coronary arteries
237 Citations1970Richard J Frink, Richard W. P. Achor +3 more
The presence of myocardial infarction associated with coronary artery calcification but without complete occlusion suggests that the advanced sclerosis of these vessels made them relatively insufficient to meet the needs of the myocardium.
The American Journal of CardiologyQuantitation of coronary arterial narrowing at necropsy in sudden coronary death
229 Citations1979William C. Roberts, Ancil A. Jones
The number of 5 mm coronary arterial segments narrowed 76 to 100 percent in cross-sectional area in the 31 study patients was not affected by the patient's age of death, sex, presence or absence of previous angina pectoris or myocardial infarction or the weight of the heart.
The American Journal of CardiologyDeterminants and protective potential of coronary arterial collaterals as assessed by an angioplasty model
226 Citations1988K.Peter Rentrop, John C. Thornton +2 more
The data of both study phases suggest that left ventricular function and clinical outcome after abrupt coronary closure are determined by an interaction between location of the coronary artery obstruction and the amount of collateral flow.
JAMAThe Framingham Study: The Epidemiology of Atherosclerotic Disease
226 Citations1981Robert I. Levy
Dr Dawber has produced an informative book whose purpose, he states, is to tell the "entire story of the Framingham Study—a narrative that without being too detailed would give the reader a reasonably complete knowledge of the overall project."
The American Journal of CardiologyValue of maximal exercise tests in risk assessment of primary coronary heart disease events in healthy men
219 Citations1980Robert A. Bruce, Timothy A. DeRouen +3 more
Exercise testing identified a small group (1 percent of the total population) who had the highest 5 year probability of primary coronary heart disease (0.33), and four variables obtained from the response to symptom-limited maximal exercise testing were significantly associated with subsequent primary coronaryHeart disease events.
CirculationCoronary Calcification
219 Citations1965Douglas A. Eggen, Jack P. Strong +1 more
The prevalence of ischemic myocardial lesions, complicated coronary lesions, or stenotic lesions was greater for cases with calcified lesions, and this prevalence increases with increase in extent of calcification.
Journal of the American College of CardiologyFamily history as an independent risk factor for coronary artery disease
214 Citations1984Steven Shea, Ruth Ottman +3 more
Observations indicate that some of the risk associated with family history is independent of familial aggregation of other known risk factors and suggest that the independent effects of family history may be most important in individuals who otherwise are at low risk.
CirculationCoronary Artery Calcium in Acute Coronary Syndromes
194 Citations1997Axel Schmermund, Dietrich Baumgart +7 more
The vast majority of patients with acute coronary syndromes and at least moderate angiographic disease have identifiable coronary calcium by EBCT, and those patients with negative EBCTs have minimal or no atherosclerotic plaque formation.
Calcified Tissue InternationalCoronary arterial calcification as an active process: A new perspective on an old problem
184 Citations1994Terence M. Doherty, Robert Detrano
Evidence reviewed here suggests that calcification is not passive precipitation or adsorption, but instead is organized and regulated and Gla containing proteins and other proteins normally associated with bone metabolism appear to play an important role in this process.
The American Journal of CardiologyComparison of serial quantitative evaluation of calcified coronary artery plaque by ultrafast computed tomography in persons with and without obstructive coronary artery disease
179 Citations1991Warren R. Janowitz, Arthur S. Agatston +1 more
Serial ultrafast CT accurately tracks the progression of coronary artery calcium and may be useful for studying the natural history of CAD and the effects of intervention on the course of CAD.
HeartIncidence and significance of coronary artery calcification.
174 Citations1974Julia McCarthy, F. J. Palmer
Postmortem angiographic studies and microcopical examinations indicate that there is a close association between calcification and significant arterial atheroma and it is suggested that routinefluoroscopy should include a search for coronary calcification.
Journal of the American College of CardiologyComparison of electron beam computed tomography scanning and conventional risk factor assessment for the prediction of angiographic coronary artery disease
164 Citations1998Alan D. Guerci, Louise A. Spadaro +5 more
Electron beam CT scanning offers improved discrimination over conventional risk factors in the identification of persons with any angiographic coronary disease orAngiographic obstructive coronary disease.
RadiologySmall lesions in the heart identified at electron beam CT: calcification or noise?
164 Citations1994Lawrence F. Bielak, Rachel Kaufmann +4 more
The 2-mm2-area definition of CAC was reliable and provided an accurate indication of coronary artery disease.
HeartIntravascular ultrasound imaging of angiographically normal coronary arteries: a prospective study in vivo.
158 Citations1994Junbo Ge, Raimund Erbel +5 more
Intravascular ultrasound imaging was performed to elucidate the discrepancy between clinical history and angiographic findings and to measure the diameter and area of the lumen of the normal left coronary artery in 55 patients who presented with chest pain but had normal coronary angiograms.
Journal of the American College of CardiologyIndependent and incremental value of coronary artery calcium for predicting the extent of angiographic coronary artery disease
151 Citations1999Axel Schmermund, Ali E. Denktas +5 more
Coronary calcium predicts the angiographic extent of CAD in symptomatic patients and provides independent and incremental information to the more conventional clinical parameters derived from SPECT or risk assessment.
Mayo Clinic ProceedingsElectron Beam Computed Tomography and Coronary Artery Disease: Scanning for Coronary Artery Calcification
148 Citations1996John A. Rumberger, Patrick F. Sheedy +3 more
The long-held notion of "degenerative" calcification of the coronary arteries with aging is incorrect, and data suggest that EBCT is a highly sensitive and specific test for coronary atherosclerosis and provide a basis for clinical applications when EBCt is viewed as a noninvasive method to estimate human coronary Atherosclerotic involvement and "plaque burden."
Journal of the American College of CardiologyEnhanced risk assessment for primary coronary heart disease events by maximal exercise testing: 10 years' experience of Seattle heart watch
147 Citations1983Robert A. Bruce, Kenneth F. Hossack +2 more
Observation of the exercise predictors in the absence of conventional risk factors increased the risk much less, suggesting that the use of maximal exercise testing for risk assessment in those with no clinical manifestations of disease might be limited to persons with one or more conventional risk Factors.
CirculationFast computed tomography detection of coronary calcification in the diagnosis of coronary artery disease. Comparison with angiography in patients < 50 years old.
135 Citations1994James A. Fallavollita, Alan S. Brody +3 more
A small but significant number of patients < 50 years old with angiographically significant coronary artery disease do not have coronary calcification demonstrated by fast CT, suggesting caution should be used in excluding significant coronary arteries disease on the basis of a negative fast CT study.
The American Journal of CardiologyReproducibility of the measurement of coronary calcium with ultrafast computed tomography
134 Citations1995Stephen Devries, Christopher J. Wolfkiel +3 more
The differences observed in repeated coronary calcium measurements underscores the importance of considering reproducibility issues when evaluating the significance of serial calcium scores and has important implications for planning intervention trials in which ultrafast computed tomography is used to monitor the evolution of atherosclerotic disease.
CirculationThe abnormal exercise electrocardiogram in apparently healthy men: a predictor of angina pectoris as an initial coronary event during long-term follow-up.
130 Citations1984Paul L. McHenry, J.A. O’Donnell +2 more
It is concluded that in apparently healthy middle-aged men an abnormal ST segment response to exercise is predictive of angina pectoris but not of myocardial infarction or sudden cardiac death as an initial coronary event.
American Heart JournalIs hyperglycemia associated with cardiovascular disease? The Framingham Study
128 Citations1991Peter W.F. Wilson, L. Adrienne Cupples +1 more
New England Journal of MedicineMyocardial Ischemia — Silent or Symptomatic
125 Citations1988Stephen E. Epstein, Arshed A. Quyyumi +1 more
One of Holter's two earliest publications included ambulatory elecrosis, a concept that has recently captured the imagination of investigators and physicians.
Annals of Internal MedicineCLINICAL GUIDELINE, PART 1: Guidelines for Using Serum Cholesterol, High-Density Lipoprotein Cholesterol, and Triglyceride Levels as Screening Tests for Preventing Coronary Heart Disease in Adults
123 Citations1996American College of Physicians
Evidence is insufficient, however, to recommend the HDL cholesterol level as an initial screening test because its effect on management is uncertain, and too little information is available to precisely recommend the frequency of screening.
RadiologyCoronary artery disease: prediction with in vitro electron beam CT.
122 Citations1994Susanne L. Mautner, Gisela C. Mautner +5 more
The electron beam CT calcium score appears to be an effective predictor of coronary artery disease.
Journal of the American College of CardiologyPrognostic significance of cardiac cinefluoroscopy for coronary calcific deposits in asymptomatic high risk subjects
122 Citations1994Robert Detrano, Nathan D. Wong +8 more
The presence of coronary calcific deposits incurs an increased risk of coronary heart disease events in asymptomatic high risk subjects at 1 year, independent of that incurred by standard risk factors.
Trends in Cardiovascular MedicineMolecular and cellular biology of osteopontin
119 Citations1995Cecilia M. Giachelli, Stephen M. Schwartz +1 more
This review focuses on structural, functional, and regulatory properties of osteopontin, which might be particularly relevant to cardiovascular lesion development.
The American Journal of CardiologyRelation of Coronary Calcium Score by Electron Beam Computed Tomography to Arteriographic Findings in Asymptomatic and Symptomatic Adults
118 Citations1997Alan D. Guerci, Louise A. Spadaro +6 more
The relation between coronary calcium score and severity of stenosis is highly significant, and data indicate that electron beam tomography can be used to estimate the severity of CAD in asymptomatic persons.
Journal of the American College of CardiologyInfluence of age and gender on the presence of coronary calcium detected by ultrafast computed tomography
108 Citations1995Stephen Devries, Christopher J. Wolfkiel +8 more
Differences in the pattern of coronary calcification between men and women may provide insight into the gender differences observed in the clinical development of symptomatic coronary artery disease.
The American Journal of CardiologyComparison of Electron-Beam Computed Tomography and Intracoronary Ultrasound in Detecting Calcified and Noncalcified Plaques in Patients With Acute Coronary Syndromes and No or Minimal to Moderate Angiographic Coronary Artery Disease
98 Citations1998Axel Schmermund, Dietrich Baumgart +8 more
In patients with acute coronary syndromes but no angiographically critical stenoses, there is a linear relationship between segments with calcified plaques versus segments with noncalcified plaque, however, while the mean ratio of these segments is close to 1:1, it is highly variable among individual patients.
Follow-up of Patients with Asymptomatic Myocardial Ischemia
97 Citations1984Jan Erikssen, Erik Thaulow
Although primary prevention of coronary heart disease (CHD) is the ultimate goal, secondary prevention may offer a partial solution and the medical axiom that early disease detection facilitates treatment is also valid for patients with coronary artery disease (CAD) remains to be proven.
CirculationRisk factors and angiographic coronary artery disease: a report from the coronary artery surgery study (CASS).
97 Citations1980Ronald E. Vlietstra, Robert L. Frye +4 more
American Heart JournalClinical, angiographic, and procedural determinants of major and minor coronary dissection during angioplasty
89 Citations1993Samin K. Sharma, Douglas H. Israel +3 more
A number of variables can predict the occurrence of angiographic coronary dissection after angioplasty, and major dissections constitute a small fraction of the total number but are difficult to predict differentially.
The American Journal of CardiologyMechanisms contributing to precipitation of unstable angina and acute myocardial infarction: Implications regarding therapy
83 Citations1984Stephen E. Epstein, Sebastian T. Palmeri
Therapeutic guidelines for the treatment of acutely ill patients are constructed that emphasize the need for a comprehensive yet time-efficient treatment strategy that uses nitrates, calcium channel-blocking drugs, streptokinase, heparin, aspirin and, in selected patients in an unstable condition, emergency percutaneous transluminal coronary angioplasty and coronary artery bypass grafting.
Annals of Internal MedicineThe Role of Exercise Testing in Screening for Coronary Artery Disease
82 Citations1989Harold C. Sox, Benjamin Littenberg +1 more
The effect of exercise testing is too small to justify doing this procedure routinely in healthy persons, but screening older men with risk factors for coronary artery disease may prove to be worthwhile if coronary bypass surgery is found to prolong life in asymptomatic persons.
CirculationQuantification of coronary arterial narrowing at necropsy in acute transmural myocardial infarction. Analysis and comparison of findings in 27 patients and 22 controls.
80 Citations1980William C. Roberts, Aaron Jones
The number of severely narrowed 5-mm segments of coronary artery did not correlate significantly with the patient's age at death, the presence or absence of a history of angina pectoris or healed myocardial infarction, or with heart weight.
RadiologyCoronary Artery Calcification: Its Relationship to Coronary Artery Stenosis and Myocardial Infarction
73 Citations1968R. King Warburton, John P. Tampas +2 more
The current study of autopsied hearts shows the relationship of coronary calcification to co-operative heart disease and reports on image intensification indicate that coronary artery calcification can be detected frequently in the living patient and appears to augur early arteriosclerotic heart disease.
Coronary Artery DiseaseQuantification of coronary artery calcification using ultrafast computed tomography
64 Citations1993Kouji Kajinami, Hiroyasu Seki +2 more
Partial volume effects play a key role in producing the variability of TCS determination, and log transformation should be used to interpret TCS values.
The American Journal of CardiologyRelation of peak creatine kinase levels during acute myocardial infarction to presence or absence of previous manifestations of myocardial ischemia (angina pectoris or healed myocardial infarction)
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Patients with acute MI without previous angina or healed MI have substantially higher peak CK and CK-MB levels; this implies a larger MI than in patients with previousAngina or healable MI.
Progress in Cardiovascular DiseasesClinical applications of dynamic computed tomography
13 Citations1986Martin J. Lipton, Bruce H. Brundage +2 more
The purpose of this article is to describe the current clinical applications of cardiac CT scanning now possible, using presently available whole body scanners and the future prospects for greatly improved imaging with recently developed high speed CT systems.
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