EBT and Coronary Artery Calcium

1
EBT and Coronary Artery Calcium

• Coronary Artery Calcium IS Atherosclerosis
• There are NO false positive calcium measures
• by EBT i.e. ALL calcium is plaque

• Establishes a diagnosis of
• coronary atherosclerosis

2
Coronary Calcium Area by EBT and Coronary Artery
Plaque Area
n 38
r 0.90
p lt .001
Rumberger, Circ 1995922157-62
3
Acute Coronary Syndrome and Non-Obstructive CAD
of segments with EBT calcium vs. of segments
with any plaque
7
Y -0.67 (0.90 X) r 0.86 p lt 0.0001 N
40 patients total of 222 coronary segments
examined
6
5
4
No. of calcified coronary segments/pt. (EBCT)
Schmermund et al AJC 1998 81 141-146
3
2
1
0
0
1
2
3
4
5
6
7
No. of coronary segments/pt. with plaques (IVUS)
4
EBT and Coronary Artery Calcium

• The amount of calcium correlates DIRECTLY to
• the amount of measurable coronary disease
  by
• 1) direct histopathologic comparison
• 2) with intravascular ultrasound

• Define the extent of disease? YES

5
Electron Beam Tomography
Area 15 mm2 Volume 12 mm3 x10-3 Agatston
(area) Score vs. Volume Score
Area 8 mm2 Volume 6 mm3 x10-3 Agatston (area)
Score vs. Volume Score
Total Score S
6
Risk of MI, SCD or Ischemia initially
asymptomatic adults
Arad JACC 2000361253-60
3.5 yr. f/u n 1177
Agatston Circ 1997
3-6 yr. f/u n 367
Odds Ratio
EBCT Calcium Score