The Heinz Nixdorf Recall Study and Its Potential Impact on the Adoption of Atherosclerosis Imaging in European Primary Prevention Guidelines

  • Amir A. Mahabadi
  • Stefan Möhlenkamp
  • Susanne Moebus
  • Nico Dragano
  • Hagen Kälsch
  • Marcus Bauer
  • Karl-Heinz Jöckel
  • Raimund Erbel
  • on behalf of the Heinz Nixdorf Investigator Group


Non–contrast-enhanced computed tomography (CT) imaging of the heart enables noninvasive quantification of coronary artery calcification (CAC), a surrogate marker of the atherosclerotic burden in the coronary artery tree. Multiple studies have underlined the ability of CAC score for individual risk stratification and, accordingly, the American Heart Association recommended cardiac CT for risk assessment in individuals with an intermediate risk of cardiovascular events as measured by Framingham Risk Score. However, limitations in transcribing risk stratification algorithms based on American cohort studies into European populations have been acknowledged in the past. Moreover, data on implications for reclassification into higher- or lower-risk groups based on CAC scores were lacking. The Heinz Nixdorf Recall (HNR) study is a population-based cohort study that investigated the ability of CAC scoring in risk prediction for major cardiovascular events above and beyond traditional cardiovascular risk factors. According to Heinz Nixdorf Recall findings, CAC can be used for reclassification, especially in those in the intermediate-risk group, to advise on lifestyle changes for the reclassified low-risk category, or to implement intensive treatments for the reclassified high-risk individuals. This article discusses the present findings of the Heinz Nixdorf Recall Study with respect to the current literature, risk stratification algorithms, and current European guidelines for risk prediction.


Coronary artery calcification Heinz Nixdorf Recall Study Risk prediction Primary prevention European guidelines Electron beam computed tomography 



No conflicts of interest relevant to this article were reported.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Amir A. Mahabadi
    • 1
  • Stefan Möhlenkamp
    • 1
  • Susanne Moebus
    • 2
  • Nico Dragano
    • 2
  • Hagen Kälsch
    • 1
  • Marcus Bauer
    • 1
  • Karl-Heinz Jöckel
    • 2
  • Raimund Erbel
    • 1
  • on behalf of the Heinz Nixdorf Investigator Group
    • 1
    • 2
  1. 1.Department of Cardiology, West-German Heart Center EssenUniversity of Duisburg-EssenEssenGermany
  2. 2.Institute of Medical InformaticsUniversity of Duisburg-EssenEssenGermany

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