title: Calcified coronary artery plaque measurement with cardiac CT in population-based studies: standardized protocol of Multi-Ethnic Study of Atherosclerosis (MESA) and Coronary Artery Risk Development in Young Adults (CARDIA) study.
abstract: Calcified coronary artery plaque, measured at cardiac computed tomography (CT), is a predictor of cardiovascular disease and may play an increasing role in cardiovascular disease risk assessment. The Multi-Ethnic Study of Atherosclerosis (MESA) and the Coronary Artery Risk Development in Young Adults (CARDIA) study of the National Heart, Lung, and Blood Institute are population-based studies in which calcified coronary artery plaque was measured with electron-beam and multi-detector row CT and a standardized protocol in 6814 (MESA) and 3044 (CARDIA study) participants. The studies were approved by the appropriate institutional review board from the study site or agency, and written informed consent was obtained from each participant. Participation in the CT examination was high, image quality was good, and agreement for the presence of calcified plaque was high (kappa = 0.92, MESA; kappa = 0.77, CARDIA study). Extremely high agreement was observed between and within CT image analysts for the presence (kappa > 0.90, all) and amount (intraclass correlation coefficients, >0.99) of calcified plaque. Measurement of calcified coronary artery plaque with cardiac CT is well accepted by participants and can be implemented with consistently high-quality results with a standardized protocol and trained personnel. If predictive value of calcified coronary artery plaque for cardiovascular events proves sufficient to justify screening a segment of the population, then a standardized cardiac CT protocol is feasible and will provide reproducible results for health care providers and the public.
authors.affiliation: Departments of Radiology and Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
authors.forename: J Jeffrey
authors.initials: JJ
authors.lastname: Carr
authors.forename: Jennifer Clark
authors.initials: JC
authors.lastname: Nelson
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.forename: Michael
authors.initials: M
authors.lastname: McNitt-Gray
authors.forename: Yadon
authors.initials: Y
authors.lastname: Arad
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Stephan
authors.initials: S
authors.lastname: Sidney
authors.forename: Diane E
authors.initials: DE
authors.lastname: Bild
authors.forename: O Dale
authors.initials: OD
authors.lastname: Williams
authors.forename: Robert C
authors.initials: RC
authors.lastname: Detrano
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000208:ethnology; D002985:Clinical Protocols; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000208:ethnology; D005260:Female; D006801:Humans; D008297:Male; D011786:Quality Control; D012107:Research Design; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000592:standards; D014481:United States