Coronary calcium on electron beam tomography imaging as a surrogate markerof coronary artery disease

Although currently recognized risk factors for coronary artery disease are helpful to predict the development of atherosclerosis, their ability to ide ntify individual patients at risk of events is limited. Therefore, surrogat e markers are being investigated to identify disease in its early phases in an attempt to decrease cardiovascular morbidity and mortality. Coronary ar tery calcification is a useful surrogate marker of coronary artery disease, and it can be visualized and measured noninvasively by means of electron b eam tomography (EBT) imaging, Atherosclerosis starts to infiltrate the arte rial intima layer much before luminal stenosis develops. Calcium is present in the large majority of mature atherosclerotic plagues, although, in rare cases, it may be absent. Recent research indicates that in selected patien t subsets, coronary calcium may add incremental prognostic value to convent ional risk factors for coronary artery disease and should therefore be used in association with such factors. EBT imaging for detection of arterial ca lcification is best employed in asymptomatic individuals at intermediate ri sk of coronary artery disease, symptomatic patients at low risk of coronary artery disease, and to track disease progression. (C)2001 by Excerpta Medi co, Inc.