CORONARY CALCIUM TESTS SHOWN TO BE RELIABLE PREDICTOR OF HEART ATTACK RISK
Landmark findings show that coronary calcium scores, taken with traditional risk factors, are more accurate predictors than risk factors alone among several racial and ethnic groups
(LONG ISLAND, NY / LOS ANGELES, CA) – A team of physicians nationwide, including a cardiologist from St. Francis Hospital, The Heart Center, recently found that a simple, rapid coronary calcium test, taken into account with traditional risk factors, is the most accurate predictor of possible cardiac events among whites, blacks, Hispanics and people of Chinese descent. The results, recently published in the New England Journal of Medicine, were derived from a study that had a larger – and more racially and ethnically diverse – cohort than previous studies.
Furthermore, researchers found that the predictive value of coronary calcium scores did not vary among the racial and ethnic groups in the study, leading researchers to believe that the findings could apply to ethnic groups not included in the study cohort. Dr. Alan Guerci, a lead researcher in the study, titled the Multi-Ethnic Study of Atherosclerosis (META), is a cardiologist who serves as the President and C.E.O. of St. Francis Hospital.
“Our findings confirm what earlier, more limited studies have shown – that the amount of coronary calcification in one’s heart and blood vessels, when taken along with other risk factors such as blood pressure, cholesterol levels and body mass, is a reliable predictor of a person’s risk of heart attack or other cardiac event,” said Dr. Guerci.
“What makes this study significantly different, besides taking coronary calcium scores into account, is the diversity of our cohort, which comprised more than 6,700 African-Americans, Hispanics, whites and Chinese-Americans. We firmly believe that these findings can – and should – be universally applied, and that the use of rapid CT scans to determine coronary calcification becomes a more routine part of the regular medical checkup for the middle-aged and elderly.”
METHODOLOGY AND SUMMARY OF FINDINGS
As part of the META study, researchers collected data on risk factors and performed scanning for coronary calcium in a population-based sample of 6,722 men and women, of whom 38.6% were white, 27.6% were black, 21.9% were Hispanic, and 11.9% were Chinese. The study subjects had no clinical cardiovascular disease at entry and were followed for a median of 3.8 years. The results were as follows:As part of the META study, researchers collected data on risk factors and performed scanning for coronary calcium in a population-based sample of 6,722 men and women, of whom 38.6% were white, 27.6% were black, 21.9% were Hispanic, and 11.9% were Chinese. The study subjects had no clinical cardiovascular disease at entry and were followed for a median of 3.8 years. The results were as follows:
- There were 162 coronary events among members of the cohort, of which 89 were major events – myocardial infarction (heart attack) or death from coronary heart diseases.
- In comparison with participants with no coronary calcium, the adjusted risk of a coronary event was increased by a factor of 7.73 among participants with coronary calcium scores between 101 and 300, and by a factor of 9.67 among participants with scores above 300 (P<0.001 for both comparisons).
- Among the four racial and ethnic groups (whites, blacks, Hispanics and Chinese), a doubling of the calcium score increased the risk of a major coronary event by 15 to 35%, and the risk of any coronary event by 18 to 39%.
- The areas under the receiver-operating-characteristic curves for the prediction of both major coronary events and any coronary event were higher when the calcium score was added to the standard risk factors.
Researchers concluded that a person’s coronary calcium score is a strong predictor of incident coronary heart disease and provides predictive information beyond that provided by standard risk factors in four major racial and ethnic groups in the United States. No major differences among racial and ethnic groups in the predictive value of calcium scores were detected.racial and ethnic groups in the predictive value of calcium scores were detected.
The article, titled Coronary Calcium as a Predictor of Coronary Events in four Racial or Ethnic Groups, was published in the March 27, 2008 issue of the New England Journal of Medicine. For an article abstract, please visit http://content.nejm.org/cgi/content/abstract/358/13/1336.
Contact:
Paul Barry, (516) 705-6657, paul.barry@chsli.org
Rosemary Gomez, (516) 705-6656, rosemary.gomez@chsli.org
