Abstract
It is increasingly recognized that only by preventing ischemic heart disease can morbidity and mortality associated with cardiovascular diseases be substantially reduced. There are two main preventive strategies: one that focuses on community-wide measures (“population approach”) and one that focuses on high-risk individuals (“high-risk approach”) (1). Certainly, both approaches have strengths and limitations, and should work best if applied in a complementary fashion. Although clear goals can be set for community-wide measures (such as promoting healthy diet, increasing physical activity, and marginalizing smoking), strategies for successful implementation depend on political, cultural, and economic surroundings. Trials in Central and Western Europe have failed to fulfil the expectations (2,3). By contrast, the high-risk approach has been demonstrated to be effective regarding both lifestyle and pharmacological interventions (1). The problem with this approach is the need to reliably identify high-risk subjects.
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References
Yusuf S, Reddy S, Ôunpuu S, Anand S. Global burden of cardiovascular disease. Part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001;104:2855–2864.
World Health Organization European Collaborative Group. European Collaborative Trial of Multifactorial Prevention of Coronary Heart Disease. Final report on the 6-year results. Lancet 1986;1:869–872.
Thelle D. Prevention of cardiovascular diseases: a scientific dilemma. Scand Cardiovasc J 2000;34:103–105.
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.
Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study [erratum: Circulation 2002;105:900]. Circulation. 2002;105:310–315.
Greenland P, Abrams J, Aurigemma GP, et al. Prevention Conference V. Beyond secondary prevention: identifying the high-risk patient for primary prevention. Noninvasive tests of atherosclerotic burden. Writing Group III. Circulation 2000;101:e16–e22.
Wald NJ, Law M, Watt HC, et al. Apolipoproteins and ischaemic heart disease: implications for screening. Lancet 1994;343:75–79.
D’Agostino RB Sr, Grundy S, Sullivan LM, Wilson P. CHD Risk Prediction Group. Validation of the Framingham coronary heart disease prediction scores: results of a multiple ethnic groups investigation. JAMA 2001; 286:180–187.
Laurier D, Chau NP, Cazelles B, Segond P. PCV METRA Group. Estimation of CHD risk in a French working population using a modified Framingham model. J Clin Epidemiol 1994;47:1353–1364.
Menotti A, Puddu PE, Lanti M. Comparison of the Framingham risk function-based coronary chart with risk function from an Italian population study. Eur Heart J 2000;21:365–370.
Hense HW, Schulte H, Lowel H, Assmann G, Keil U. Framingham risk function overestimates risk of coronary heart disease in men and women from Germany—results from the MONICA Augsburg and the PROCAM cohorts. Eur Heart J 2003;24:937–945.
Hoeg JM, Feuerstein IM, Tucker EE. Detection and quantitation of calcific atherosclerosis by ultrafast computed tomography in children and young adults with homozygous familial hypercholesterolemia. Arterioscler Thromb 1994;14:1066–1074.
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.
Schmermund A, Denktas AE, Rumberger JA, et al. Independent and incremental value of coronary artery calcium for predicting the extent of angiographic coronary artery disease: comparison with cardiac risk factors and radionuclide perfusion imaging. J Am Coll Cardiol 1999;34:777–786.
Farb A, Burke AP, Tang AL, et al. Coronary plaque erosion without rupture into a lipid core. A frequent cause of coronary thrombosis in sudden coronary death. Circulation 1996;93:1354–1364.
Burke AP, Taylor A, Farb A, Malcom GT, Virmani R. Coronary calcification: insights from sudden coronary death victims. Z Kardiol 2000;89Suppl 2:49–53.
Schmermund A, Erbel R. Current perspective: unstable coronary plaque and its relation to coronary calcium. Circulation 2001; 104:1682–1687.
Burke AP, Kolodgie FD, Farb A, et al. Healed plaque ruptures and sudden coronary death: evidence that subclinical rupture has a role in plaque progression. Circulation 2001;103:934–940.
Burke AP, Kolodgie FD, Farb A, et al. Morphological predictors of arterial remodeling in coronary atherosclerosis. Circulation 2002;105:297–303.
Raggi P, Callister TQ, Cooil B, et al. Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam computed tomography. Circulation 2000;101:850–855.
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.
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.
Park R, Detrano R, Xiang M, et al. Combined use of computed tomography coronary calcium scores and C-reactive protein levels in predicting cardiovascular events in nondiabetic individuals. Circulation 2002;106:2073–2077.
Kondos GT, Hoff JA, Sevrukov A, et al. Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymptomatic low-to intermediate-risk adults. Circulation 2003;107:2571–2576.
Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 2003;228:826–833.
Greenland P, Smith SC, Grundy SN. Current perspective: improving coronary heart disease risk assessment in asymptomatic people. Role of traditional risk factors and noninvasive cardiovascular tests. Circulation 2001;104:1863–1867.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report. Circulation 2002; 106:3143–3421.
De Backer G, Ambrosioni E, Borch-Johnsen K, et al. Executive Summary. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2003;24:1601–1610.
Vliegenthart R, Oei HH, Breteler MM, et al. Coronary calcification is a strong predictor of all-cause and cardiovascular mortality in elderly. Circulation 2002;106(Suppl):II–743.
Vliegenthart R. Coronary calcification and the risk of cardiovascular disease. An epidemiologic study. PhD Thesis. Thoraxcentre Rotterdam, Netherlands, March 19, 2003.
Arad Y, Roth M, Newstein D, Guerci A. Coronary calcification, coronary disease risk factors, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. Hotline Session, ACC 2003.
Schmermund A, Baumgart D, Möhlenkamp S, et al. Natural history and topographic pattern of progression of coronary calcification in symptomatic patients: an electron-beam CT study. Arterioscler Thromb Vasc Biol 2001;21:421–426.
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© 2005 Humana Press, Inc., Totowa, NJ
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Schmermund, A., Möhlenkamp, S., Erbel, R. (2005). Coronary Calcium Scanning. In: Schoepf, U.J. (eds) CT of the Heart. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-818-8:079
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DOI: https://doi.org/10.1385/1-59259-818-8:079
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