Electron beam computed tomographic coronary calcium scanning: A review and guidelines for use in asymptomatic persons
Electron beam computed tomographic coronary calcium scanning: A review and guidelines for use in asymptomatic persons
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DOI：
10.4065/74.3.243
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发表时间：
1999-03-01
影响因子：
8.9
通讯作者：
Kondos, G
中科院分区：
文献类型：
--
作者：
Rumberger, JA;Brundage, BH;Kondos, G
冠状动脉疾病是发达国家的头号死因。有效的治疗手段，如降低胆固醇水平的药物治疗是可用的，但对高危患者的临床应用仍然不明确。电子束计算机断层扫描（EBCT）被认为是诊断亚临床冠状动脉疾病和促进危险分层的一种手段，但目前在临床实践中尚未达成共识。我们从临床角度批判性地回顾了当前有关EBCT冠状动脉钙扫描的相关文献，特别是将其作为动脉粥样硬化性冠状动脉疾病的测量方法的研究。此外，我们回顾了量化EBCT“钙评分”与冠心病事件之间关系的研究。现有数据表明，EBCT钙评分可以帮助识别未来冠状动脉事件风险高于预期的人群。EBCT冠状动脉钙化评分越高，动脉粥样硬化斑块病变程度越大。基于文献回顾，我们提供EBCT解释指南，因为它们与药物治疗和降低胆固醇水平处于边缘的无症状患者的风险有关。大量证据表明，冠状动脉钙化是动脉粥样硬化斑块特异性的，使用EBCT可以敏感地检测和准确地量化冠状动脉钙化。冠状动脉钙评分可以帮助指导临床预防方案的启动，作为风险分层和管理方案的一部分，旨在改善相应年龄和性别的冠状动脉疾病最高风险患者的预后。
Coronary artery disease is the No. 1 cause of death in the developed world. Effective means of treatment such as drug therapy to lower cholesterol levels are available, but clinical application to patients at highest risk remains imprecise. Electron beam computed tomography (EBCT) has been suggested as a means to diagnose subclinical coronary disease and facilitate risk stratification, but no current interpretive consensus exists in clinical practice. We critically reviewed current, pertinent literature regarding EBCT coronary calcium scanning from a clinical perspective and, in particular, studies that evaluated it as a measure of atherosclerotic coronary disease, Additionally, me reviewed studies that quantified the EBCT "calcium score" in relationship to coronary heart disease events, The available data suggest that the EBCT calcium score can help identify persons at higher than anticipated risk of future coronary events: the greater the EBCT coronary calcium score, the greater the extent of atherosclerotic plaque disease, Based on the literature review, we offer EBCT interpretation guidelines as they relate to drug therapy and risk reduction in asymptomatic persons with borderline cholesterol levels, Considerable evidence shows that coronary calcium is specific for atherosclerotic plaque and that it can be sensitively detected and accurately quantified by using EBCT, The coronary calcium score can help guide initiation of clinical prevention programs as part of a risk stratification and management scheme aimed at improving outcomes in patients determined to be at highest risk of coronary disease for their respective age and gender.