RELATION OF CORONARY CALCIUM SCORE BY ELECTRON-BEAM COMPUTED-TOMOGRAPHY TO ARTERIOGRAPHIC FINDINGS IN ASYMPTOMATIC AND SYMPTOMATIC ADULTS

Coronary arteriography was performed on 18 asymptomatic, apparently he althy adults with elevated coronary calcium scores. To extend the rang e of observation to subjects with tow calcium scores, arteriograms fro m 18 patients with exertional dyspnea and/or valvular heart disease an d low calcium scores were also analyzed; these 18 patients were consid ered asymptomatic from the point of view of coronary artery disease (C AD). For the comparison of symptomatic and asymptomatic persons, 3 age and sex-matched symptomatic patients were also selected for each of t he original 18 asymptomatic subjects. Arteriograms were analyzed by co mputer-assisted quantitative coronary arteriography at ct remote site without knowledge of the calcium score or any other patient characteri stics. In the 18 asymptomatic subjects with elevated calcium scores, t he mean calcium score was 573 +/- 504 (Agatston method) and the mean w orst stenosis was 45% +/- 16%. For all 36 patients without symptoms of CAD, worst stenosis was closely correlated with the square root of th e calcium score (r = 0.85, p <0.0001). patients with symptomatic coron ary disease and calcium scores <1,000 had stenoses more severe than as ymptomatic persons with similar calcium scores. Most asymptomatic adul ts with elevated calcium scores have nontrivial, nonobstructive CAD or preclinical obstructive CAD, and the relation between coronary calciu m score and severity of stenosis is highly significant. These data ind icate that electron beam tomography can be used to estimate the severi ty of CAD in asymptomatic persons. (C) 1997 by Excerpta Medica, Inc.