What does my patient's coronary artery calcium score mean? Combining information from the coronary artery calcium score
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BioMed Central
Open Access
Research article
What does my patient's coronary artery calcium score mean? Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk Mark J Pletcher*1,2, Jeffrey A Tice2,1, Michael Pignone3, Charles McCulloch1, Tracy Q Callister4 and Warren S Browner5,1,6 Address: 1Department of Epidemiology and Biostatistics, University of California, San Francisco 500 Parnassus Ave, MU 420 West, Box 0560, San Francisco, CA 94143-0560, USA, 2Division of General Internal Medicine, University of California, San Francisco, CA, USA, 3Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina – Chapel Hill School of Medicine, Chapel Hill, NC, USA, 4EBT Research Foundation, Nashville, TN, USA, 5Research Institute, California Pacific Medical Center, San Francisco, CA, USA and 6Department of Medicine, University of California, San Francisco, CA, USA Email: Mark J Pletcher* - [email protected]; Jeffrey A Tice - [email protected]; Michael Pignone - [email protected]; Charles McCulloch - [email protected]; Tracy Q Callister - [email protected]; Warren S Browner - [email protected] * Corresponding author
Published: 24 August 2004 BMC Medicine 2004, 2:31
doi:10.1186/1741-7015-2-31
Received: 20 April 2004 Accepted: 24 August 2004
This article is available from: http://www.biomedcentral.com/1741-7015/2/31 © 2004 Pletcher et al; licensee BioMed Central Ltd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The coronary artery calcium (CAC) score is an independent predictor of coronary heart disease. We sought to combine information from the CAC score with information from conventional cardiac risk factors to produce post-test risk estimates, and to determine whether the score may add clinically useful information. Methods: We measured the independent cross-sectional associations between conventional cardiac risk factors and the CAC score among asymptomatic persons referred for non-contrast electron beam computed tomography. Using the resulting multivariable models and published CAC score-specific relative risk estimates, we estimated post-test coronary heart disease risk in a number of different scenarios. Results: Among 9341 asymptomatic study participants (age 35–88 years, 40% female), we found that conventional coronary heart disease risk factors including age, male sex, self-reported hypertension, diabetes and high cholesterol were independent predictors of the CAC score, and we used the resulting multivariable models for predicting post-test risk in a variety of scenarios. Our models predicted, for example, that a 60-year-old non-smoking non-diabetic women with hypertension and high cholesterol would h
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