The use of electron-beam computed tomography as a tool for primary prevention

Coronary artery disease (CAD) is the most common cause of death in the Unit ed States, and most acute CAD events occur unexpectedly in patients unaware of their condition. Consequently, attention has recently focused on the de velopment of new technologies for the early detection of CAD, such as elect ron-beam computed tomography (EBCT). With EBCT imaging, the coronary artery tree is visualized noninvasively and vascular calcification, a marker of a therosclerotic disease, is easily detected and its extent quantified. Curre nt research suggests that the presence of coronary artery calcification on a screening EBCT image provides relevant prognostic information for the dev elop-ment of future coronary events. Furthermore, preliminary evidence sugg ests that the use of EBCT to observe the progression of disease, as demonst rated by changes in the coronary calcium burden on sequential studies, is a viable and exciting new application. The Beyond Endorsed Lipid Lowering wi th EBCT Scanning (BELLES) trial will use EBCT to compare the effects of 12 months of treatment with aggressive or moderate statin therapy on the progr ession of coronary atherosclerosis. (C) 2001 by Excerpta Medica, Inc.