Coronary calcium scoring: Calcium location needs to be integrated!

Li, Z. Y., Sadat, U., & Gillard, J. H. (2009) Coronary calcium scoring: Calcium location needs to be integrated! Journal of the American College of Cardiology, 54(8), p. 745.

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Coronary calcium scoring (CCS) has been a topic of great interest lately. In a large population-based study comprising 6,722 patients, Detrano et al. (1) have effectively shown that CCS can be a strong predictor of incident coronary heart disease among different racial groups. Henneman et al. (2) have, however, reported that CCS does not reliably exclude the presence of (significant) atherosclerosis. This topic is quite controversial as there is significant evidence from Detrano's work that higher CCS is associated with an increased risk of acute coronary events.

We think that the location of calcium within the coronary arteries should also be considered. Li et al. (3,4) have shown that the position of the calcium in the plaque is a better determinant of plaque vulnerability than the total calcium load. Using a biomechanical model, predicted maximum stress was found to increase by 47.5% when calcium deposits were located in the thin fibrous cap. The presence of calcium deposits in the lipid core or remote from the fibrous cap resulted in no increase in maximum stress. It was also noted that the presence of calcification within the lipid core may even stabilize the plaque.

Integration of calcium location in CCS will, therefore, enable better assessment of severity of atherosclerosis and prediction of future cardiovascular events.

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ID Code: 90335
Item Type: Journal Article
Refereed: Yes
DOI: 10.1016/j.jacc.2009.04.064
ISSN: 1558-3597
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Current > Institutes > Institute of Health and Biomedical Innovation
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Copyright Owner: Copyright 2009 American College of Cardiology Foundation
Deposited On: 16 Nov 2015 03:44
Last Modified: 02 Dec 2015 05:47

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