Population-based assessment of subclinical coronary atherosclerosis using electron-beam computed tomography.
OBJECTIVE
Coronary artery calcification (CAC) is determined as a measure of the extent of coronary atherosclerosis and can be used for expanded cardiovascular risk stratification. It was our aim to establish reference CAC scores in a population-based unselected European cohort.


RESULTS
The Heinz Nixdorf Recall study (HNR) recruited a total of 4814 participants aged 45-74 years. Cardiovascular risk factors and medications were recorded, and CAC was measured using electron-beam CT (EBCT). CAC score distribution was compared with previous studies in subjects who were self-referred, volunteered, or were physician-referred. Of the 4472 (92.9%) subjects free of clinical coronary artery disease, the CAC score was available in 4275 (95.3%) (2027 men, 2248 women). CAC scores were lower in particular in the higher age groups (> or = 60 years) in men than in the previous studies. Also, in most age groups (except the highest, 70-74 years), subjects with no cardiovascular medications had significantly lower CAC scores than subjects using cardiovascular medications.


CONCLUSIONS
The current report characterises the distribution of EBCT-derived CAC scores in a European unselected population. Compared with previous reports, CAC scores were lower in our cohort, in particular in subjects not receiving cardiovascular medications. Classification of the CAC score may underestimate true risk if previously published referral cohorts are used as the reference.
Schmermund
Axel
A
Cardioangiologisches Centrum, Bethanien, Im Prüfling 23, D-60389 Frankfurt am Main, Germany. a.schmermund@ccb.de
Möhlenkamp
Stefan
S
Berenbein
Sina
S
Pump
Heiko
H
Moebus
Susanne
S
Roggenbuck
Ulla
U
Stang
Andreas
A
Seibel
Rainer
R
Grönemeyer
Dietrich
D
Jöckel
Karl-Heinz
KH
Erbel
Raimund
R
D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D014055:Tomography, Emission-Computed