Advertisement

Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults

      Abstract

      Electron beam tomography (EBT) is a noninvasive method used to detect coronary artery calcium (CAC). Due to the age-associated increase in incidence and magnitude of CAC, interpretation of results can be difficult. The purpose of this study was to develop a set of age- and gender-stratified CAC distributions to serve as standards for the clinical interpretation of EBT scans. Between 1993 and 1999, 35,246 asymptomatic subjects, 30 to 90 years of age, were self-referred for CAC screening using an Imatron EBT scanner. CAC score was calculated based on the number, areas, and peak computed tomographic density for each detected calcific lesion. CAC score in each coronary artery was equal to the sum of all lesions for that artery and the total CAC score was equal to the sum of the score of each artery. Total CAC scores were assigned to a percentile according to age and gender. CAC scores were reported at the 10th, 25th, 50th, 75th, and 90th percentiles for 16 age and/or gender groups. The prevalence of CAC increased with age for men and women. The extent of CAC differed significantly between men and women in the same age group. In summary, this study reports the distribution of CAC score by age and gender. Knowledge of the distribution of CAC, the effect of age on the total CAC score as well as the differences in total CAC scores that exist between men and women of similar age will assist the clinician in interpreting EBT CAC results.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rumberger J.A.
        • Brundage B.H.
        • Rader D.J.
        • Kondos G.T.
        Electron beam computed tomographic coronary calcium scanning.
        Mayo Clin Proc. 1999; 74: 243-252
        • O’Rourke R.A.
        • Brundage B.H.
        • Froelicher V.F.
        • Greenland P.
        • Grundy S.M.
        • Hachamovitch R.
        • Pohost G.M.
        • Shaw L.J.
        • Weintraub W.S.
        • Winters Jr, W.L.
        • et al.
        ACC/AHA Expert consensus document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease.
        Circulation. 2000; 102: 126-140
        • Wexler L.
        • Brundage B.
        • Crouse J.
        • Detrano R.
        • Fuster V.
        • Maddahi J.
        • Rumberger J.
        • Stanford W.
        • White R.
        • Taubert K.
        Coronary artery calcium.
        Circulation. 1996; 94: 1175-1192
        • Stanford W.
        • Thompson B.H.
        Imaging of coronary artery calcification.
        Radiol Clin North Am. 1999; 37: 257-272
        • Wong N.D.
        • Vo A.
        • Abrahamson D.
        • Tobis J.M.
        • Eisenberg H.
        • Detrano R.C.
        Detection of coronary artery calcium by ultrafast computed tomography and its relation to clinical evidence of coronary artery disease.
        Am J Cardiol. 1994; 73: 223-227
        • Fallavollita J.A.
        • Brody A.S.
        • Bunnell I.L.
        • Kumar K.
        • Canty J.M.
        Fast computed tomography detection of coronary calcification in the diagnosis of coronary artery disease.
        Circulation. 1994; 89: 285-290
        • Agatston A.S.
        • Janowitz W.R.
        • Hildner F.J.
        • Zusmer N.R.
        • Viamonte M.
        • Detrano R.
        Quantification of coronary artery calcium using ultrafast computed tomography.
        J Am Coll Cardiol. 1990; 15: 827-832
        • Kajinami K.
        • Takekoshi N.
        Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography.
        J Am Coll Cardiol. 1995; 25: 626-632
        • Guerci A.D.
        • Spadaro L.A.
        • Popma J.J.
        • Goodman K.J.
        • Brundage B.H.
        • Lerner G.
        • Vizza R.F.
        Relation of coronary calcium score by electron beam computed tomography to arteriographic findings in asymptomatic and symptomatic adults.
        Am J Cardiol. 1997; 79: 128-133
        • Rumberger J.A.
        • Simons B.
        • Fitzpatrick L.A.
        • Sheedy P.F.
        • Schwartz R.S.
        Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area.
        Circulation. 1995; 92: 2157-2162
        • Mautner S.L.
        • Mautner G.C.
        • Froehlich J.
        • Feuerstein I.M.
        • Proschan M.A.
        • Roberts W.C.
        • Doppman J.L.
        Coronary artery disease.
        Radiology. 1994; 192: 625-630
        • Arad Y.
        • Spadaro L.A.
        • Goodman K.
        • Lledo-Perez A.
        • Sherman S.
        • Lerner G.
        • Guerci A.D.
        Predictive value of electron beam computed tomography of the coronary arteries.
        Circulation. 1996; 93: 1951-1953
        • Detrano R.
        • Hsiai T.
        • Wang S.
        • Puentes G.
        • Fallavollita J.
        • Shields P.
        • Stanford W.
        • Wolfkiel C.
        • Georgiou D.
        • Budoff M.
        • Reed J.
        Prognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography.
        J Am Coll Cardiol. 1996; 27: 285-290
        • Secci A.
        • Wong N.
        • Tang W.
        • Doherty T.
        • Detrano R.
        Electron beam computed tomographic coronary calcium as a predictor of coronary events.
        Circulation. 1997; 96: 1122-1129
        • Rumberger J.A.
        • Sheedy P.F.
        • Breen J.F.
        • Schwartz R.S.
        Coronary calcium, as determined by electron beam computed tomography, and coronary disease on arteriogram.
        Circulation. 1995; 91: 1363-1367
        • Janowitz W.R.
        • Agatston A.S.
        • Kaplan G.
        • Viamonte M.
        Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women.
        Am J Cardiol. 1993; 72: 247-254
        • Grundy S.
        Primary prevention of coronary heart disease.
        Circulation. 1999; 100: 988-998
        • Agatston A.S.
        • Janowitz W.R.
        • Hildner F.J.
        • Zustmer N.R.
        • Viamonte M.
        • Detrano R.
        Quantification of coronary artery calcium using ultrafast computed tomography.
        J Am Coll Cardiol. 1990; 15: 827-832
        • Devries S.
        • Wolfkiel C.
        • Shah V.
        • Chomka E.
        • Rich S.
        Reproducibility of the measurement of coronary artery calcium with ultrafast computed tomography.
        Am J Cardiol. 1995; 75: 973-975
      1. US Department of Commerce, Economics and Statistics Administration. 1990 Census of Population. Social and Economic Characteristics. Washington, DC: US Government Printing Office, 1993.

        • Garg R.
        • Madans J.H.
        • Kleinman J.C.
        Regional variation in ischemic heart disease incidence.
        J Clin Epidemiol. 1992; 45: 149-156
        • Howard G.
        • Manolio T.A.
        • Burke G.L.
        • Wolfson S.K.
        • O’Leary D.H.
        Does the association of risk factors and atherosclerosis change with age? An analysis of the combined ARIC and CHS cohorts. The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health Study (CHS) investigators.
        Stroke. 1997; 28: 1693-1701
      2. Callister TQ, Raggi P. Concise review: electron beam tomography for early detection of coronary heart disease. In: Braunwald E, Fauci AS, Isselbacher KJ, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s Online. www.harrisonsonline.com. New York, NY: McGraw-Hill Companies, 2000.

        • Janowitz W.R.
        • Agatston A.S.
        • Kaplan G.
        • Viamonte M.
        Differences in prevalence and extent of coronary artery calcium detected by ultrafast computed tomography in asymptomatic men and women.
        Am J Cardiol. 1993; 72: 247-254
        • He Z.-X.
        • Lakkis N.M.
        • Hedrick T.D.
        • England C.J.
        • Verfani M.S.
        • Roberts R.
        • Mahmarian J.J.
        The severity of coronary artery calcification by ultrafast computed tomography predicts patients with stress-induced myocardial ischemia.
        J Am Coll Cardiol. 1997; 29 (abstr): 393A
        • Rumberger J.A.
        • Sheedy P.F.
        • Breen J.F.
        • Schwartz R.S.
        Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen stenosis.
        J Am Coll Cardiol. 1997; 29: 1542-1548
        • Heller R.F.
        • Chinn S.
        • Pedoe H.D.
        • Rose G.
        How well can we predict coronary heart disease? Findings in the United Kingdom heart disease prevention project.
        BMJ. 1984; 288: 1409-1411
        • Wald N.J.
        • Law M.
        • Watt H.C.
        • Wu T.
        • Bailey A.
        • Johnson A.M.
        • Craig W.Y.
        • Ledue T.B.
        • Haddow J.E.
        Apolipoproteins and ischaemic heart disease.
        Lancet. 1994; 343: 75-79