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Coronary calcium score predicts coronary events in 4 major ethnic groups By Reuters Health March 28, 2008
NEW YORK (Reuters Health), Mar 28 - The coronary calcium score is of equal value as an independent predictor of incident heart disease in white, black, Hispanic, and Chinese residents of the U.S., according to a paper in the New England Journal of Medicine for March 27.
Nevertheless, the cost-effectiveness of calcium scoring has yet to be determined, authors of an accompanying editorial maintain.
Dr. Robert Detrano, at the University of California at Irvine, and associates used computed tomography to quantify coronary artery calcium in 6722 participants in the Multi-Ethnic Study of Atherosclerosis (MESA), of whom 38.6% were white, 27.6% were black, 21.9% were Hispanic, and 11.9% were Chinese.
During follow-up for a median of 3.8 years, there were 162 coronary events, including 89 deemed to be major events (MI or death from coronary heart disease).
In comparison with no coronary calcium, the adjusted risk of a coronary event was increased more than sevenfold for coronary calcium scores between 101 and 300, and by more than ninefold for scores above 300 (p < 0.001 for both).
"The coronary calcium score contributed to the risk of both major events and any event in four major ethnic groups independently of other risk factors," Dr. Detrano's team reports.
In their editorial, Dr. William S. Weintraub, from the Christiana Care Health System in Newark, DE, and Dr. George A. Diamond, at Cedars-Sinai Medical Center in Los Angeles, suggest that the coronary calcium score may offer little advantage over the far less expensive Framingham score.
"In principle," they write, "if improved outcomes could be shown as a result of coronary calcium scoring, if those improved outcomes could be translated into improved survival or health status, and if the cost of calcium scoring and downstream costs related to additional testing, therapies, and events could be predicted, then the cost-effectiveness of calcium scoring could be determined."
For now, the editorialists say, all these issues remain open to question.
NEW YORK (Reuters Health), Mar 28 - The coronary calcium score is of equal value as an independent predictor of incident heart disease in white, black, Hispanic, and Chinese residents of the U.S., according to a paper in the New England Journal of Medicine for March 27.
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