Skip Navigation

European Heart Journal 2002 23(20):1596-1603; doi:10.1053/euhj.2002.3240
Copyright © 2002 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (34)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Vliegenthart, R.
Right arrow Articles by Witteman, J.C.M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vliegenthart, R.
Right arrow Articles by Witteman, J.C.M.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Coronary calcification detected by electron-beam computed tomography and myocardial infarction. The Rotterdam Coronary Calcification Study

R. Vliegentharta,b, M. Oudkerkb,c, B. Songd, D.A.M. van der Kuipa, A. Hofmana and J.C.M. Wittemana,f1

a Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
b Department of Radiology, State University Groningen/University Hospital Groningen, Groningen, The Netherlands
c Department of Radiology, Daniel den Hoed Clinic, Erasmus Medical Centre, Rotterdam, The Netherlands
d Department of Radiology, The First University Hospital Chengdu, Chengdu, China

revised March 4, 2002; accepted March 6, 2002

Abstract

Aims Available data are insufficient to determine the relation between coronary calcification and coronary events in the general population. We cross-sectionally examined the association between coronary calcification and myocardial infarction in the prospective Rotterdam Coronary Calcification Study.

Methods and Results From 1997 onwards, subjects were invited for electron-beam computed tomography scanning to detect coronary calcification. The study was embedded in the population-based Rotterdam Study. Calcifications were quantified in a calcium score according to Agatston’s method. Calcium scores were available for 2013 participants with a mean age of 71 years (standard deviation, 5·7 years). A history of myocardial infarction prior to scanning was present in 229 subjects. Compared to subjects in the lowest calcium score category (0–100), the age-adjusted odds ratio for myocardial infarction in subjects in the highest calcium score category (above 2000) was 7·7 (95% confidence interval, 4·1–14·5) for men, and 6·7 (95% confidence interval, 2·4–19·1) for women. Additional adjustment for cardiovascular risk factors only slightly altered the estimates. The association was observed across all age subgroups, i.e. also in subjects of 70 years and older.

Conclusion A strong and graded association was found between coronary calcification and myocardial infarction. The association remained at high ages. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Calcium, coronary disease, elderly, epidemiology, myocardial infarction, tomography

f1 Correspondence: Dr J. C. M. Witteman, Department of Epidemiology & Biostatistics, Erasmus Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.

References

  1. Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area: a histopathologic correlative study. Circulation. 1995;92:2157–2162[Abstract/Free Full Text]
  2. Sangiorgi G, Rumberger JA, Severson A. Arterial calcification and not lumen stenosis is highly correlated with atherosclerotic plaque burden in humans: a histologic study of 723 coronary artery segments using nondecalcifying methodology. J Am Coll Cardiol. 1998;31:126–133[Abstract/Free Full Text]
  3. Schmermund A, Bailey KR, Rumberger JA, Reed JE, Sheedy PF, Schwartz RS. An algorithm for noninvasive identification of angiographic three-vessel and/or left main coronary artery disease in symptomatic patients on the basis of cardiac risk and electron-beam computed tomographic calcium scores. J Am Coll Cardiol. 1999;33:444–452[Abstract/Free Full Text]
  4. Bielak LF, Rumberger JA, Sheedy PF, Schwartz RS, Peyser PA. Probabilistic model for prediction of angiographically defined obstructive coronary artery disease using electron beam computed tomography calcium scores strata. Circulation. 2000;102:380–385[Abstract/Free Full Text]
  5. Detrano RC, Wong ND, Doherty TM. Coronary calcium does not accurately predict near-term future coronary events in high-risk adults. Circulation. 1999;99:2633–2638[Abstract/Free Full Text]
  6. Raggi P, Callister TQ, Cooil B. Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam computed tomography. Circulation. 2000;101:850–855[Abstract/Free Full Text]
  7. Wong ND, Hsu JC, Detrano RC, Diamond G, Eisenberg H, Gardin JM. Coronary artery calcium evaluation by electron beam computed tomography and its relation to new cardiovascular events. Am J Cardiol. 2000;86:495–498[CrossRef][ISI][Medline]
  8. Arad Y, Spadaro LA, Goodman K, Newstein D, Guerci AD. Prediction of coronary events with electron beam computed tomography. J Am Coll Cardiol. 2000;36:1253–1260[Abstract/Free Full Text]
  9. Hofman A, Grobbee DE, de Jong PT, van den Ouweland FA. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol. 1991;7:403–422[CrossRef][ISI][Medline]
  10. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte MJ, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827–832[Abstract]
  11. Kaufmann RB, Sheedy PF II, Breen JF. Detection of heart calcification with electron beam CT: interobserver and intraobserver reliability for scoring quantification. Radiology. 1994;190:347–352[Abstract/Free Full Text]
  12. van Bemmel JH, Kors JA, van Herpen G. Methodology of the modular ECG analysis system MEANS. Methods Inf Med. 1990;29:346–353[ISI][Medline]
  13. Willems JL, Abreu-Lima C, Arnaud P. The diagnostic performance of computer programs for the interpretation of electrocardiograms. N Engl J Med. 1991;325:1767–1773[Abstract]
  14. World Health Organization, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Geneva, World Health Organization, 1992
  15. de Bruyne MC, Mosterd A, Hoes AW. Prevalence, determinants, and misclassification of myocardial infarction in the elderly. Epidemiology. 1997;8:495–500[CrossRef][ISI][Medline]
  16. van Gent CM, van der Voort HA, de Bruyn AM. Cholesterol determinants. A comparative study of methods with special reference to enzymatic procedures. Clin Chim Acta. 1977;75:243–251[CrossRef][ISI][Medline]
  17. Diabetes Care. 2001;24:S5–S20
  18. Doherty TM, Detrano RC, Mautner SL, Mautner GC, Shavelle RM. Coronary calcium; the good, the bad, and the uncertain. Am Heart J. 1999;137:806–814[CrossRef][ISI][Medline]
  19. Shemesh J, Stroh CI, Tenenbaum A. Comparison of coronary calcium in stable angina pectoris and in first acute myocardial infarction utilizing double helical computerized tomography. Am J Cardiol. 1998;81:271–275[CrossRef][ISI][Medline]
  20. Mascola A, Ko J, Bakhsheshi H, Budoff MJ. Electron beam tomography comparison of culprit and non-culprit coronary arteries in patients with acute myocardial infarction. Am J Cardiol. 2000;85:1357–1359[CrossRef][ISI][Medline]
  21. Schermund A, Baumgart D, Möhlenkamp S. Natural history and tomographic pattern of progression of coronary calcification in symptomatic patients. An electron-beam CT study. Arterioscler Thromb Vasc Biol. 2001;21:421–426[Abstract/Free Full Text]
  22. Wong ND, Vo A, Abrahamson D, Tobis JM, Eisenberg H, Detrano RC. 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[CrossRef][ISI][Medline]
  23. Wilson PWF, D’Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847[Abstract/Free Full Text]
  24. Chambless LE, Heiss G, Folsom AR. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities Study, 1987–1993. Am J Epidemiol. 1997;146:483–494[Abstract/Free Full Text]
  25. Salonen JT, Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb. 1991;11:1245–1249[Abstract/Free Full Text]
  26. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam study. Circulation. 1997;96:1432–1437[Abstract/Free Full Text]
  27. O’Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. N Engl J Med. 1999;340:14–22[Abstract/Free Full Text]
  28. Criqui MH, Langer RD, Fronek A, Feigelson HS. Coronary disease and stroke in patients with large-vessel peripheral arterial disease. Drugs. 1991;42:16–21
  29. Newman AB, Sutton-Tyrrell K, Vogt MT, Kuller LH. Morbidity and mortality in hypertensive adults with a low ankle/arm blood pressure index. JAMA. 1993;270:487–489[Abstract]
  30. Ogren M, Hedblad B, Jungquist G, Isacsson SO, Lindell SE, Janzon L. Low ankle-brachial pressure index in 68-year-old men: prevalence, risk factors and prognosis. Results from prospective population study ‘Men born in 1914’, Malmo, Sweden. Eur J Vasc Surg. 1993;7:500–506[CrossRef][ISI][Medline]

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
J EndocrinolHome page
C. van Noord, W. M van der Deure, M. C J M Sturkenboom, S. M J M Straus, A. Hofman, T. J Visser, J. A Kors, J. C M Witteman, and B. H C. Stricker
High free thyroxine levels are associated with QTc prolongation in males
J. Endocrinol., July 1, 2008; 198(1): 253 - 260.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
M. P. Schenker, S. Dorbala, E. C. T. Hong, F. J. Rybicki, R. Hachamovitch, R. Y. Kwong, and M. F. Di Carli
Interrelation of Coronary Calcification, Myocardial Ischemia, and Outcomes in Patients With Intermediate Likelihood of Coronary Artery Disease: A Combined Positron Emission Tomography/Computed Tomography Study
Circulation, April 1, 2008; 117(13): 1693 - 1700.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
O. Leontiev and T. J. Dubinsky
CT-Based Calcium Scoring to Screen for Coronary Artery Disease: Why Aren't We There Yet?
Am. J. Roentgenol., November 1, 2007; 189(5): 1061 - 1063.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. D. Guerci
The Prognostic Accuracy of Coronary Calcification
J. Am. Coll. Cardiol., May 8, 2007; 49(18): 1871 - 1873.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
Y. Arad, L. A. Spadaro, M. Roth, D. Newstein, and A. D. Guerci
Treatment of Asymptomatic Adults With Elevated Coronary Calcium Scores With Atorvastatin, Vitamin C, and Vitamin E: The St. Francis Heart Study Randomized Clinical Trial
J. Am. Coll. Cardiol., July 5, 2005; 46(1): 166 - 172.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
T. Ueland, R. Jemtland, K. Godang, J. Kjekshus, A. Hognestad, T. Omland, I. B. Squire, L. Gullestad, J. Bollerslev, K. Dickstein, et al.
Prognostic value of osteoprotegerin in heart failure after acute myocardial infarction
J. Am. Coll. Cardiol., November 16, 2004; 44(10): 1970 - 1976.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
D. S. Berman, N. D. Wong, H. Gransar, R. Miranda-Peats, J. Dahlbeck, S. W. Hayes, J. D. Friedman, X. Kang, D. Polk, R. Hachamovitch, et al.
Relationship between stress-induced myocardial ischemia and atherosclerosis measured by coronary calcium tomography
J. Am. Coll. Cardiol., August 18, 2004; 44(4): 923 - 930.
[Abstract] [Full Text] [PDF]


Home page
Arch Intern MedHome page
M. J. Pletcher, J. A. Tice, M. Pignone, and W. S. Browner
Using the Coronary Artery Calcium Score to Predict Coronary Heart Disease Events: A Systematic Review and Meta-analysis
Arch Intern Med, June 28, 2004; 164(12): 1285 - 1292.
[Abstract] [Full Text] [PDF]


Home page
Diabetes CareHome page
P. D. Reaven and J. Sacks
Reduced Coronary Artery and Abdominal Aortic Calcification in Hispanics With Type 2 Diabetes
Diabetes Care, May 1, 2004; 27(5): 1115 - 1120.
[Abstract] [Full Text] [PDF]


Home page
RadiologyHome page
R. Vliegenthart, B. Song, A. Hofman, J. C. M. Witteman, and M. Oudkerk
Coronary Calcification at Electron-Beam CT: Effect of Section Thickness on Calcium Scoring in Vitro and in Vivo
Radiology, November 1, 2003; 229(2): 520 - 525.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
C. Daly, P. Saravanan, and K. Fox
Is calcium the clue?
Eur. Heart J., October 2, 2002; 23(20): 1562 - 1566.
[Full Text] [PDF]


This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (34)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Vliegenthart, R.
Right arrow Articles by Witteman, J.C.M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Vliegenthart, R.
Right arrow Articles by Witteman, J.C.M.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?