Coronary Artery Calcification by Computed Tomography in Epidemiologic Research and Cardiovascular Disease Prevention

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Author(s)

    • SEKIKAWA Akira
    • Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
    • CURB J. David
    • Department of Geriatric Medicine, the John A. Burns School of Medicine, University of Hawaii
    • OKAMURA Tomonori
    • Department of Preventive Medicine and Public Health, School of Medicine, Keio University
    • CHOO Jina
    • Department of Community Health Nursing, College of Nursing, Korea University
    • MASAKI Kamal
    • Department of Geriatric Medicine, the John A. Burns School of Medicine, University of Hawaii
    • KULLER Lewis H.
    • Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
    • SHIN Chol
    • Department of Internal Medicine, Korea University

Abstract

Both American and European guidelines recommend coronary artery calcification (CAC) as a tool for screening asymptomatic individuals at intermediate risk for coronary heart disease (CHD). These recommendations are based on epidemiologic studies mostly in the United States. We review (1) the use of CAC in primary prevention of CHD in the United States, (2) epidemiologic studies of CAC in asymptomatic adults outside of the United States, and (3) international epidemiologic studies of CAC. This review will not consider clinical studies of CAC among patients or symptomatic individuals. US studies have shown that CAC is a strong independent predictor of CHD in both sexes among middle-aged and old age groups, various ethnic groups, and individuals with and without diabetes and that CAC plays an important role in reclassifying individuals from intermediate to high risk. Studies in Europe support these conclusions. The Electron-Beam Tomography, Risk Factor Assessment Among Japanese and US Men in the Post-World-War-II birth cohort (ERA JUMP) Study is the first international study to compare subclinical atherosclerosis, including CAC among Japanese, Japanese Americans, Koreans, and whites. It showed that as compared with whites, Japanese had lower levels of atherosclerosis, whereas Japanese Americans had similar or higher levels. CAC is being increasingly used as a screening tool for asymptomatic individuals in Europe and the United States. CAC is a powerful research tool, because it enables us to describe differences in atherosclerotic burden across populations. Such research could identify factors responsible for differences among populations, which may improve CHD prevention.

Journal

  • Journal of Epidemiology

    Journal of Epidemiology 22(3), 188-198, 2012-05-01

    Japan Epidemiological Association

References:  116

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Codes

  • NII Article ID (NAID)
    10030617938
  • NII NACSIS-CAT ID (NCID)
    AA10952696
  • Text Lang
    ENG
  • Article Type
    REV
  • ISSN
    09175040
  • DOI
    10.2188/jea.JE20110138
  • Data Source
    CJP  J-STAGE 
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