Prognostic Significance of Coronary Calcific Deposits in Asymptomatic High-Risk Subjects
Section snippets
Recruitment of Subjects
The South Bay Heart Watch in Torrance, California, is a government-funded, prospective cohort study designed to test the value of radiographically detectable coronary calcification in predicting coronary heart disease outcome in high-risk asymptomatic adults. After a preliminary newspaper advertising campaign, we mailed 100,000 letters of invitation to households whose head was at least 45 years of age. These letters invited subjects with at least two coronary risk factors to participate in a
Patient Characteristics and Completeness of Follow-Up
The age, gender, and risk factor profile of the South Bay Heart Watch cohort are described in Table 1. All subjects were above 75th percentile of coronary heart disease risk.9, 14
All but one patient (99.9%) were successfully contacted during the first follow-up attempt. Follow-up rate remained over 98 percent for all four follow-up attempts.
Fluoroscopic Results
Fifty-eight percent of this cohort (852 subjects) had fluoroscopically detectable coronary calcium: 437 (30%) of the subjects had detectable calcium in only
Discussion
Pathologically confirmed coronary calcification always indicates the presence of coronary atherosclerosis.15, 16 The ubiquity of atherosclerosis in the Western world, therefore, is consistent with the high prevalence of radiographic coronary calcification seen in this and other studies.17, 18, 19 Despite this high prevalence, the observed 5-year incidence of coronary heart disease death and infarction in our cohort is only 5.3%. Therefore, when coronary atherosclerosis is detected by sensitive
Acknowledgements
Particular gratitude must be extended to Drs. Bruce Brundage, Kenneth Narahara, Demetrios Georgiou, and William French for their assistance as part of the ECG reading and adjudication committees. The nursing support of Oleh Brezden and Gail Puentes is deeply appreciated. Dr. Weiyi-Tang contributed greatly as Associate Director of the South Bay Heart Watch. Eddie F. Rodrigues and Ramon M. Valencia provided technical and editorial assistance.
This work was supported by Grant 7R01-HL-43277-02 from
References (28)
- et al.
Mechanism of calcification in atherosclerosis
Trends Card Med.
(1994) - et al.
Prevalence of fluoroscopic coronary calcific deposits in high-risk asymptomatic persons
Am Heart J.
(1994) - et al.
Coronary calcium and atherosclerosis by ultrafast computed tomography in asymptomatic men and women: relation to age and risk factors
Am Heart J.
(1994) - et al.
Fluoroscopic coronary artery calcification and associated coronary disease in asymptomatic young men
J Am Coll Cardiol.
(1992) - et al.
Detection of coronary artery calcium by ultrafast computed tomography and its relation to clinical evidence of coronary artery disease
Am J Cardiol.
(1994) - et al.
Risk factors for coronary artery disease in persons older than 62 years in a long-term health care facility
Am J Cardiol.
(1986) - et al.
Prognostic value of coronary calcification and angiographic stenosis in patients undergoing coronary arteriography
J Am Coll Cardiol.
(1996) - et al.
Plaque fissuring—the cause of acute myocardial infarction, sudden ischemic death, and crescendo angina
Br Heart J.
(1985) - et al.
Distribution of circumferential stress in ruptured and stable atherosclerotic lesions: a structural analysis with histopathological correlation
Circulation.
(1993) Effect of calcification on in-vivo mechanical response of rabbit arteries to balloon dilatation
Circulation.
(1991)