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Coronary calcium may be heart attack risk factor.

Patient at risk for heart attack may someday be identified through a quick, non-invasive scan for improperly metabolized calcium deposits in their corwnary arteries.

Recent research on nearly 600 patients using a relatively new type of X-ray scan, ultrafast computerized tomography (CT), provided a sensitive measure of calcium in the arterial walls. Calcium, invariably linked with atherosclerosis or "hardening of the arteries," increased alongside other risk factors such as age, gender, history of smoking and hypertension.

Writing in the American Journal of Cardiology, the researchers reported on a study of 458 men abd 139 women, one of the largest studies associating coronary atherosclerosis detected by CT calcium screening with a wide spectrum of cariovascular risk factors.

"We found a strong association between the presence of calcium and other risk factors such as age and a history of smoking," said Nathan Wong, director of the preventive cardiology program at the University of California College of Medicine. "However, the power of the CT sacn to predict heart attacks has yet to be established and will depend on further study."

If ultrafast CT scanning turns out to be a predictor of heart attacks, the technique, in conjunction with known risk factors, could provide a sensitive, noninvasive method of testing patients. Currently, other noninvasive methods such as exercise treadmill testing have significant false-positive and false-negative rates.

Finding more sensitive and accurate predictors of heart attacks is important because many patients show no outward symptoms before their first attack, which is immediately fatal in approximately one-third of cases.

Corroborating earlier studies of various heart attack risk factors, the researchers found that calcium levels increased with conditions such as elevated cholesterol and high blood pressure. In fact, the number of risk factors and total calcium score, based on the computed volume and density of calcium in heart arteries, went up together in a graded fashion.

There was a large increase in the prevalence of detectable calcium between a group of men aged 40 to 49 and one aged 50 to 59 -- jumping from 44 percent in the first group with detectable calcium to 70 percent in the older group. A similar jump occurred in women ages 50 and 59 (29 percent) and 60 to 69 (71 percent).

Previous tobacco use was the strongest indicator other than age or gender for detectable calcium in both men and women.

Currently, only a few facilities are equipped for CT evaluations of coronary calcium but Wong believes the technique has the potential to become a standard test for preventive cardiology.
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Publication:Nutrition Health Review
Date:Jan 1, 1993
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