Archivos de Cardiología de México

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Archivos de Cardiología de México >Year 2000, Issue 6

Sierra-Galán LM, Hernández-López JE, Portos-Silva JM
Correlation of coronary arteries by helix computed tomography vs angiography
Arch Cardiol Mex 2000; 70 (6)

Language: Español
References: 53
Page: 569-579
PDF: 249.91 Kb.

Full text


Introduction: The calcium score (CS) of the coronary arteries by computed tomography (CT) is an useful procedure for the diagnosis of obstructive coronary disease (OCD), with an average sensitivity of 82 ± 6%, specificity of 88 ± 2%, positive predictive value (PPV) of 57 ± 7% and negative predictive value (NPV) of 96 ± 2%. The objective of this trial was to compare helicoidal CT Scan with the traditional method and define sensitivity, specificity, Positive predictive value and negative predictive value against the coronary angiography. Methods: From June of 1998 to March of 1999, one hundred and sixty six patients with coronary arteries CT were studied. The CT was done with an ELSCINT-CT Twin equipment and a software for the quantification of the coronary arteries CS in Hounsfield units. In forty one, coronary angiography was performent. A significant obstructive lesion was defined as ≥ 70% of luminal stenosis in at least one artery, or ≥ 50% in the left main and ≥ 50% if some other artery was involved. This group was divided in accordance to the CS in two subgroups: A with a CS ≤ 150 and B those with a CS ≥ 151. Results: In group A, 45% had significative lesions vs 95% in group B (p = 0.001). The sensitivity was 65%, specificity 95%, PPV 64% and the NPV 92%. Relative risk 2.08 (CI 95% 1.38-3.54) and Odds ratio 21.6 (CI 95% 2.43-191.37). Conclusions: Even though the small sample, CT is an useful procedure for the diagnosis of the OCD.

Key words: Coronary arteries tomography, Coronary calcification, Coronary atherosclerosis.


  1. Rosamond WD, Chambless LE, Folsom AR, et al: Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994 [see comments]. N Engl J Med 1998; 339: 861-7.

  2. Levy D, Thom TJ: Death rates from coronary disease-progress and a puzzling paradox [editorial; comment] [see comments]. N Engl J Med 1998; 339: 915-7.

  3. Rumberger JA, Brundage BH, Rader DJ, Kondos G: Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons [published erratum appears in Mayo Clin Proc 1999 May; 74(5): 538]. Mayo Clin Proc 1999; 74: 243-52.

  4. Knopp RH: Drug treatment of lipid disorders. New England Joumal of Medicine 1999; 341: 498-511.

  5. Murray CJ, Lopez AD: Mortality by cause for eight regions of the world: Global Burden of Disease Study [see comments]. Lancet 1997; 349: 1269-76.

  6. Sasaki F, Koga S, Takeuchi A: [Computed tomographic detection of calcification within the heart and the thoracic aorta (author’s transl)]. Nippon Igaku Hoshasen Gakkai Zasshi 1982; 42: 123-9.

  7. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viarnonte M, Jr., Detrano R: Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827-32.

  8. Haberl R, Knez A, Becker A, Becker C, Maass A, Bruning R, et al: [Significance of calcium detection with electron-beam tomography in coronary disease]. Radiologe 1998; 38: 999-1005.

  9. Callister TQ, Cooil B, Raya SP, Lippolis NJ, Russo DJ, Raggi P: Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method [see comments]. Radiology 1998; 208: 807-14.

  10. Arad Y, Spadaro LA, Roth M, Scordo J, Goodman K, Sherinan S, et al: Correlations between vascular calcification and atherosclerosis: a comparative electron beam CT study of the coronary and carotid arteries. J Comput Assist Tomogr 1998; 22: 207-11.

  11. Janowitz WR, Agatston AS, Viamonte M, Jr: Comparison of serial quantitative evaluation of calcified coronary artery plaque by ultrafast computed tomography in persons with and without obstructive coronary artery disease. Am J Cardiol 1991; 68: 1-6.

  12. Schmermund A, Rumberger JA, Colter JF, Sheedy PF, 2nd, Schwartz RS: Angiographic correlates of “spotty” coronary artery calcium detected by electron-beam computed tomography in patients with normal or near-normal coronary angiograms. Am J Cardiol 1998; 82: 508-11.

  13. Sangiorgi G, Rumberger JA, Severson A, Edwards WD, Gregoire J, Fitzpatrick LA, et al: 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: 126-33.

  14. Rumberger JA, Sheedy PF, Breen JF, Schwartz RS: Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen stenosis. J Am Coll Cardiol 1997; 29: 1542-8.

  15. 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 [see comments]. Circulation 1995; 92: 2157-62.

  16. Vallabhajosula S, Fuster V: Atherosclerosis: imaging techniques and the evolving role of nuclear medicine. J Nucl Med 1997; 38: 1788-96.

  17. Schmermund A, Baumgart D, Gorge G, Seibel R, Gronemeyer D, Erbel R: Non-invasive visualization of coronary arteries with and without calcification by electron beam computed tomography. Herz 1996; 21: 118-26.

  18. Mautner GC, Mautner SL, Froehlich J, Feuerstein IM, Proschan MA, Roberts WC, et al. Coronary artery calcification: assessment with electron beam CT and histomorphometric correlation [see comments]. Radiology 1994; 192: 619-23.

  19. Wexler L, Brundage B, Crouse J, Detrano R, Fuster V, Maddahi J, et al: Coronary artery calcification: pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation 1996; 94: 1175-92.

  20. Fuster V, Lewis A: Conner Memorial Lecture. Mechanisms leading to myocardial infarction: insights from studies of vascular biology [published erratum appears in Circulation 1995 Jan 1; 91(1): 256]. Circulation 1994; 90: 2126-46.

  21. Mailhac A, Badimon JJ, Fallon JT, Fernandez-Ortiz A, Meyer B, Chesebro JH, et al: Effect of an eccentric severe stenosis on fibrin (ogen) deposition on severely damaged vessel wall in arterial thrombosis. Relative contribution of fibrin (ogen) and platelets. Circulation 1994; 90: 988-96.

  22. Moreno PR, Falk E, Palacios IF, Newell JB, Fuster V, Fallon JT: Macrophage infiltration in acute coronary syndromes. Implications for plaque rupture. Circulation 1994; 90: 775-8.

  23. Schmerinund A, Bailey KR, Rumberger JA, Reed JE, Sheedy PF, 2nd, 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: 444-52.

  24. Maher JE, Raz JA, Bielak LF, Sheedy PF, 2nd, Schwartz RS, Peyser PA: Potential of quantity of coronary artery calcification to identify new risk factors for asymptomatic atherosclerosis. Am J Epidemiol 1996; 144: 943-53.

  25. Behrenbeck T, Gerber TC, Rumberger JA: [Electron beam tomography in cost effective diagnosis of coronary heart disease]. Radiologe 1996; 36: 327-36.

  26. Farb A, Burke AP, Tang AL, Liang TY, Mannan P, Smialek J, et al: Coronary plaque erosion without rupture into a lipid core. A frequent cause of coronary thrombosis in sudden coronary death. Circulation 1996; 93: 1354-63.

  27. Budoff MJ, Georgiou D, Brody A, Agatston AS, Kennedy J, Wolfkiel C, et al: Ultrafast computed tomography as a diagnostic modality in the detection of coronary artery disease: a multicenter study. Circulation 1996; 93: 898-904.

  28. Selvester RH, Ahmed J, Tolan GD: Asymptomatic coronary artery disease detection: update 1996. A screening protocol using 16-lead high-resolution ECG, ultrafast CT, exercise testing, and radionuclear imaging. J Electrocardiol 1996; 29: 135-44.

  29. Guerci AD, Spadaro LA, Popma JJ, Goodman KJ, Brundage BH, Budoff M, et al: Relation of coronary calcium score by electron beam computed tomography to arteriographic findings in asymptomatic and symptomatic adults. Am J Cardiol 1997; 79: 128-33.

  30. Kajinami K, Seki H, Takekoshi N, Mabuchi H: Coronary calcification and coronary atherosclerosis: site by site comparative morphologic study of electron beam computed tomography and coronary angiography. J Am Coll Cardiol 1997; 29: 1549-56.

  31. Myocardial infarction and mortality in the coronary artery surgery study (CASS) randomized trial. N Engl J Med 1984; 310: 750-8.

  32. Rumberger JA, Sheedy PF, 3rd, Breen JF, Schwartz RS: Coronary calcium, as determined by electron beam computed tomography, and coronary disease on arteriogram. Effect of patient’s sex on diagnosis [see comments]. Circulation 1995; 91: 1363-7

  33. Breen JF, Sheedy PFd, Schwartz RS, et al: Coronary artery calcification detected with ultrafast CT as an indication of coronary artery disease. Radiology 1992; 185: 435-9.

  34. Masuda Y, Takasu J, Kumai T, Naitou S: [Evaluation of arterial sclerosis by CT, MR imaging and MR angiography]. Nippon Rinsho 1993; 51: 2037-42.

  35. Plainfosse MC: [Detection of coronary calcifications and coronary disease]. Presse Med 1994; 23: 845-7.

  36. Rumberger JA, Schwartz RS, Simons DB, Sheedy PF, 3rd, Edwards WD, Fitzpatrick LA: Relation of coronary calcium determined by electron beam computed tomography and lumen narrowing determined by autopsy. Am J Cardiol 1994; 73: 1169-73.

  37. Yaghoubi S, Tang W, Wang S, et al: Offline assessment of atherosclerotic coronary calcium from electron beam tomograms. Am J Card Imaging 1995; 9: 231-6.

  38. Schmennund A, Rensing BJ, Sheedy PF, Bell MR, Rumberger JA: Intravenous electron-beam computed tomographic coronary angiography for segmental analysis of coronary artery stenoses. J Am Coll Cardiol 1998; 31: 1547-54.

  39. Yamamoto H, Imazu M, Hattori Y, Tadehara F, Yamakido M, Nakanishi T, et al: Predicting angiographic narrowing > or = 50% in diameter in each of the three major arteries by amounts of calcium detected by electron beam computed tomographic scanning in patients with chest pain. Am J Cardiol 1998; 81: 778-80.

  40. Erbel R, Ge J, Gorge G, Mohlenkamp S, Baumgart D, von Birgelen C, et al: [New imaging methods for visualizing coronary arteries]. Z Kardiol 1998; 87: 61-73.

  41. Becker CR, Knez A, Jakobs TF, et al. Detection and quantification of coronary artery calcification with electron-beam and conventional CT. Eur Radiol 1999; 9: 620-4.

  42. Stanford W, Thompson BH. Imaging of coronary artery calcification: Its importance in assessing atherosclerotic disease. Radiol Clin North Am 1999; 37: 257-72.

  43. Rumberger JA, Behrenbeck T, Breen JF, Sheedy PF, 2nd: Coronary calcification by electron beam computed tomography and obstructive coronary artery disease: a model for costs and effectiveness of diagnosis as compared with conventional cardiac testing methods. J Am Coll Cardiol 1999; 33: 453-62.

  44. Maher JE, Bielak LF, Raz JA, Sheedy PF, 2nd, Schwartz RS, Peyser PA: Progression of coronary artery calcification: a pilot study. Mayo Clin Proc 1999; 74: 347-55.

  45. Greaser LE, 3rd, Yoon HC, Mather RT, McNitt-Gray M, Goldin JG: Electron-beam CT: the effect of using a correction function on coronary artery calcium quantitation. Acad Radiol 1999; 6: 40-8.

  46. Schmermund A, Baumgart D, Gorge G, Gronemeyer D, Seibel R, Bailey KR, et al: Measuring the effect of risk factors on coronary atherosclerosis: coronary calcium score versus angiographic disease severity [published erratum appears in J Am Coll Cardiol 1998 Aug; 32(2): 555]. J Am Coll Cardiol 1998; 31: 1267-73.

  47. Schmermund A, Baumgart D, Adamzik M, et al: Comparison of electron-beam computed tomography and intracoronary ultrasound in detecting calcified and noncalcified plaques in patients with acute coronary syndromes and no or minimal to moderate angiographic coronary artery disease. Am J Cardiol 1998; 81: 141-6.

  48. Reddy GP, Chemoff DM, Adains JR, Higgins CB: Coronary artery stenoses: assessment with contrast-enhanced electron-beam CT and axial reconstructions. Radiology 1998; 208: 167-72.

  49. Baumgart D, Schmermund A, Goerge G, et al: Comparison of electron beam computed tomography with intracoronary ultrasound and coronary angiography for detection of coronary atherosclerosis. J Am Coll Cardiol 1997; 30: 57-64.

  50. Nakanishi T, Ito K, Imazu M, Yamakido M: Evaluation of coronary artery stenoses using electron-beam CT and multiplanar reformation. J Comput Assist Tomogr 1997; 21: 121-7.

  51. Rumberger JA, Sheedy PF, 2nd, Breen JF, Fitzpatrick LA, Schwartz RS: Electron beam computed tomography and coronary artery disease: scanning for coronary artery calcification. Mayo Clin Proc 1996; 71: 369-77.

  52. Erbel R, Ge J, Bockisch A, Keamey P, Gorge G, Haude M, et al: Value of intracoronary ultrasound and Doppler in the differentiation of angiographically normal coronary arteries: a prospective study in patients with angina pectoris. Eur Heart J 1996; 17: 880-9.

  53. Shemesh J, Tenenbaum A, Fisman EZ, Apter S, Rath S, Rozenman J, et al: Absence of coronary calcification on double-helical CT scans: predictor of angiographically normal coronary arteries in elderly women? Radiology 1996; 199: 665-8.

  54. Detrano R, Hsiai T, Wang S, et al: Prognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography [see comments]. J Am Coll Cardiol 1996; 27: 285-90.

  55. Stanford W, Travis ME, Thompson BH, Reiners TJ, Hasson RR, Winniford MD: Electron-beam computed tomographic detection of coronary calcification in patients undergoing percutaneous transluminal coronary angioplasty: predictability of restenosis. A preliminary report. Am J Card Imaging 1995; 9: 257-60.

  56. Thomas PJ, McCollough CH, Ritman EL: An electron-beam CT approach for transvenous coronary arteriography. J Comput Assist Tomogr 1995; 19: 383-9.

  57. Patterson RE, Horowitz SF, Eisner RL: Comparison of modalities to diagnose coronary artery disease. Semin Nucl Med 1994; 24: 286-310.

  58. Khan A, Mond DJ, Kallman CE, Murata K, Rojas KA, Herman PG: Computed tomography of normal and calcified coronary arteries. J Thorac Imaging 1994; 9: 1-7.

  59. Kosling S, Hoffmann U, Rother T, Lieberenz S, Heywang-Kobrunner SH, Schulz HG: [Detection of coronary calcification by ultrafast CT compared with coronary angiography]. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 1994; 161: 501-4.

  60. Sandrick K: Cine CT shows calcium prior to onset of CAD. Diagn Imaging (San Franc) 1992; 14: 83-4, 92.

  61. Masuda Y, Naito S, Aoyagi Y, Yamada Z, Uda T, Morooka N, et al: Coronary artery calcification detected by CT: clinical significance and angiographic correlates. Angiology 1990; 41: 1037-47.

  62. 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: 1066-74.

  63. Schmermund A, Baumgart D, Gorge G, Seibel R, Gronemeyer D, Ge J, et al: Coronary artery calcium in acute coronary syndromes: a comparative study of electron-beam computed tomography, coronary angiography, and intracoronary ultrasound in survivors of acute myocardial infarction and unstable angina [see comments]. Circulation 1997; 96: 1461-9.

>Journals >Archivos de Cardiología de México >Year 2000, Issue 6

· Journal Index 
· Links 

Copyright 2019