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Natural History and Impact of Interventions on Coronary Calcium

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Cardiac CT Imaging

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Conclusion

The data presented in this chapter provide evidence that non-invasive CT imaging can be used to monitor the effectiveness of medical therapy by following changes in burden of calcified plaque. Nonetheless, there are some limitations inherent with the technology currently available. There is a strong need to standardize the scoring methods and assess the equivalence of the existing CT equipment. Additionally, the rigid application of a density threshold of 130 HU to define the presence of vascular or valvular calcification in all patients limits our ability to identify more recent, less densely calcified and therefore softer plaques. Though further prospective studies will be necessary to confirm the clinical significance of the findings herein summarized, it is quite evident that the effectiveness of anti-atherosclerotic therapy can be gauged with sequential CT imaging. The application of this technology will greatly facilitate primary and secondary prevention studies by allowing a great reduction in the number of patients needed to show effectiveness of therapy. Simultaneously, a physician’s effort to implement preventive measures could be gratified by the ability to measure the effectiveness of the applied remedies. Interventions directed at modifying risk factors associated with atherosclerosis besides LDL such as small-density LDL, Lp(a), low HDL, elevated homocysteine levels, and use of anti-viral and anti-bacterial agents will likely be the focus of future research.

With continued improvements in CT technology and expanded clinical experience, it is hoped that the role of coronary calcium in primary and secondary prevention will be further defined and become more readily accepted by a wider circle of physician users.

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Author information

Authors and Affiliations

  1. Department of Cardiology, Tulane University School of Medicine, New Orleans, LA, USA

    Paolo Raggi MD

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  1. Paolo Raggi MD
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Editor information

Editors and Affiliations

  1. Los Angeles Biomedical Research, Institute at Harbor-UCLA Medical Center, Torrance, CA, USA

    Matthew J. Budoff MD, FACC, FAHA

  2. Division of Cardiovascular Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA

    Jerold S. Shinbane MD, FACC

  3. Department of Internal Medicine II, University of Erlangen, Erlangen, Germany

    Stephan Achenbach MD, FESC

  4. Department of Cardiology, Tulane University School of Medicine, New Orleans, LA, USA

    Paolo Raggi MD

  5. Cardiovascular Disease, The Ohio State University, Dublin, OH, USA

    John A. Rumberger PhD, MD

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© 2006 Springer-Verlag London Limited

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Raggi, P. (2006). Natural History and Impact of Interventions on Coronary Calcium. In: Budoff, M.J., Shinbane, J.S., Achenbach, S., Raggi, P., Rumberger, J.A. (eds) Cardiac CT Imaging. Springer, London . https://doi.org/10.1007/1-84628-146-6_7

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  • DOI: https://doi.org/10.1007/1-84628-146-6_7

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-028-3

  • Online ISBN: 978-1-84628-146-4

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