title: [Assessment of the natural history of coronary artery calcification and identification of its determinants. Rationale of the 2nd part of the Heinz Nixdorf Recall Study].
abstract: The Heinz Nixdorf Recall Study, which was inaugurated in 2000, is an ongoing population-based study to evaluate the prediction of cardiovascular events by integrating new imaging and nonimaging modalities in risk assessment. A focus is the additional prognostic value of coronary artery calcification (CAC). Currently used risk stratification algorithms often describe the individuals' risk based on few established risk factors only inaccurately. Using noninvasive quantification of CAC progression, the natural history of atherosclerosis with its repetitive, frequently subclinical plaque ruptures, may detect an unstable course of the disease long before the disease irreversibly manifests in sudden death or myocardial infarction. While the independent additional prognostic value of CAC quantification has been shown in asymptomatic patients at intermediate risk, only few studies provided evidence for an independent prognostic value of serial CAC measurements. In the Heinz Nixdorf Recall Study, the impact of established and new risk factors, e.g., the metabolic syndrome, psychosocial and environmental risk factors, or genetic variables, can be assessed. Further, the association of CAC progression with the incidence of other cardiovascular diseases such as heart failure or aortic or aortic valve calcification can be described. Since April 2006, the participants of the study return to the study center 5 years after baseline recruitment to assess health status and to determine the risk factor profile. Based on recently published data, serial CAC measurements have been granted allowing for (1) characterization of the natural history of CAC progression, and (2) identification of its determinants. The rationale of serial CAC quantification is discussed in this article.The Heinz Nixdorf Recall Study will contribute to the appraisal of new imaging modalities in risk stratification.
authors.affiliation: Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Essen, Germany. stefan.moehlenkamp@uk-essen.de
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.forename: Axel
authors.initials: A
authors.lastname: Schmermund
authors.forename: Nils
authors.initials: N
authors.lastname: Lehmann
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.forename: Till
authors.initials: T
authors.lastname: Neumann
authors.forename: Andreas
authors.initials: A
authors.lastname: Stang
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.forename: Gert
authors.initials: G
authors.lastname: Kerkhoff
authors.forename: Christoph
authors.initials: C
authors.lastname: Naber
authors.forename: Hagen
authors.initials: H
authors.lastname: Kälsch
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Beck
authors.forename: Martina
authors.initials: M
authors.lastname: Bröcker-Preuss
authors.forename: Knut
authors.initials: K
authors.lastname: Kröger
authors.forename: Thomas
authors.initials: T
authors.lastname: Budde
authors.forename: Johannes
authors.initials: J
authors.lastname: Siegrist
authors.forename: Klaus
authors.initials: K
authors.lastname: Mann
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000368:Aged; D002114:Calcinosis / Q000175:diagnosis* / Q000453:epidemiology*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003625:Data Collection; D018450:Disease Progression; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors