The AHA Guidelines and Scientific Statements Handbook

Chapter 20 Cardiac CT Imaging

Table 20.1 Characteristics and Risk Ratio for Follow-Up Studies Using EBCT

Author No.

Mean

Age, y

Follow-Up

Duration, y

Calcium Score

Cutoff

Comparative

Group for RR

Calculation

Risk Factor

Assessment

Relative Risk

Ratio

EBCT studies in symptomatic cohorts
Georglou^9319253 4.2 Median* Below median Measured 13.1
Detrano^12349157 2.5 Top quartile Bottom quartile Self-reported 10.8
Keelan^12428856 6.9 Median (>480) Below median Measured 3.2
Moehlenkamp^125150635 CACP > 1000 No CACP Measured 2.5

EBCT studies in asymptomatic populations
Arad^102117353 3.6 CACP CACP Self-reported 20.2

160 < 160
Detrano^104119666 3.4 CACP > 44 CACP < 44 Measured 2.3
Park^105 (subset
of Detrano^104 )

967 67 6.4 CACP >142.1 CACP <3.7 Measured 4.9

Raggi^10763252 2.7 Top quartile† Lowest quartile Self-reported 1.3
Shemesh^11244664 3.8 CACP > 0 CACP = 0 Measured 2.8
Wong^11092654 3.3 Top quartile Lowest quartile Self-reported 8.8
Arad^114461359 4.3 CACP ≥ 100 CACP < 100 Measured 9.2
Kondos^111563551 3.1 CACP No CACP Self-reported 3.86 (men)
1.53‡ (women)
Greenland^1131266 7.0 CACP > 300 No CACP Measured 3.9
Shaw^112 10 377 53 5 CACP 401–1000 CACP ≤ 10 Self-reported 6.2§
Taylor^1152000433 CACP No CACP Measured 11.8
LaMonte^117 10 746 54 3.5 CACP top third No CACP Measured 8.7 (men)
6.3 (women)
Vliegenthart^116179571 3.3 > 1000 0–100 Measured 8.1
Becker^118924603 Top quartile (75th
percentile)

Total study

group

Measured 7.3

Duplicate series: Detrano, Park, and Greenland.
CACP indicates coronary artery calcium score; RR, relative risk ratio.

• Using age- and gender-matched cohorts, representing top quartile.
  † Using age- and gender-matched cohorts, representing the top quintile.
  ‡ After multivariate analysis, P < 0.05 for men, P = not signifi cant for women.
  § End point was all-cause mortality.

Tomography and expands the scope to both Multi-
Detector Computed Tomography (MDCT) and
covers other applications beyond calcium scoring,
including computed tomography angiography
(CTA). This statement refl ects changes since the
initial publication of these guidelines in 2000. The
Writing Committee considered evidence published
and drafted revised recommendations to incorpo-
rate results from major prospective outcome and

diagnostic trials. This paper compared MDCT and

EBCT, served as a clinical update for the use of

CACP in clinical decision-making regarding evalu-

ations for CHD in the asymptomatic individual, and

summarized current comparative evidence regard-

ing noninvasive angiography using computed

tomography. The future role of these techniques was

considered with regard to the monitoring of athero-

sclerosis and the detection of noncalcifi ed plaque.