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Coronary artery calcium scoring and its impact on the clinical practice in the era of multidetector CT

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Abstract

With the suggestion of coronary artery calcium as an indicator of coronary artery disease 30 years ago, intense and controversial discussion regarding coronary artery calcium has been ongoing. Diverse techniques for evaluation of coronary artery calcium were suggested and validation of its feasibility has been followed up. Following establishment of reference standards, coronary artery calcium became widely utilized in clinical practice and scientific research. Originally coronary artery calcium scoring techniques were developed for prediction of cardiovascular risk. Additionally, coronary artery calcium scoring has been utilized as an indicator for other medical events. Recently, coronary artery calcium scoring used to be applied as a reference standard during scientific research. In this article, the topic of coronary artery calcium, from its introduction to its current usefulness, was discussed from the viewpoints of coronary artery calcium scoring techniques, imaging modalities, validation of the techniques, clinical feasibility of coronary artery calcium scoring beyond traditional cardiovascular risk prediction, and utilization of coronary artery calcium scoring as a reference standard. Popular coronary calcium scoring techniques comprises of Agatston, volume, and mass scores. Through validation of these techniques, pros and cons of each technique were analyzed and proper utility could be suggested. In parallel, the reference standards for Agatston and volume scores were established by age, sex, and race. Through the vigorous controversies, nowadays, the clinical feasibility of coronary artery calcium score as a surrogate marker of cardiovascular risk was acknowledged in the literature.

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Abbreviations

CAC:

Coronary artery calcium

CAD:

Coronary artery disease

EBCT:

Electron beam CT

CACS:

Coronary arterial calcium score

MDCT:

Multidetector CT

ECG:

Electrocardiography

HU:

Hounsfield units

SNR:

Signal-to-noise ratio

CCTA:

Coronary CT angiography

VS:

Volume score

MS:

Mass score

CaHA:

Calcium hydroxyapatite

MESA:

Multi-ethnic study of atherosclerosis

TAC:

Thoracic aortic calcification

AVC:

Aortic valvular calcification

MAC:

Mitral annular calcium

NLR:

Neutrophil/lymphocyte ratio

LP-PLA2:

Lipoprotein-associated phospholipase A2

EPCs:

Endothelial progenitor cells

References

  1. Margolis JR, Chen JT, Kong Y et al (1980) The diagnostic and prognostic significance of coronary artery calcification. A report of 800 cases. Radiology 137(3):609–616

    PubMed  CAS  Google Scholar 

  2. Agatston AS, Janowitz WR, Hildner FJ et al (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15(4):827–832

    Article  PubMed  CAS  Google Scholar 

  3. Schmermund A, Bailey KR, Rumberger JA et al (1999) An algorithm for noninvasive identification of angiographic three-vessel and/or left main coronary artery disease in symptomatic patients on the basis of cardiac risk and electron-beam computed tomographic calcium scores. J Am Coll Cardiol 33(2):444–452

    Article  PubMed  CAS  Google Scholar 

  4. Rumberger JA, Brundage BH, Rader DJ et al (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74(3):243–252

    Article  PubMed  CAS  Google Scholar 

  5. Hoff JA, Chomka EV, Krainik AJ et al (2001) Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35, 246 adults. Am J Cardiol 87(12):1335–1339

    Article  PubMed  CAS  Google Scholar 

  6. Georgiou D, Budoff MJ, Kaufer E et al (2001) Screening patients with chest pain in the emergency department using electron beam tomography: a follow-up study. J Am Coll Cardiol 38(1):105–110

    Article  PubMed  CAS  Google Scholar 

  7. Rumberger JA, Kaufman L (2003) A rosetta stone for coronary calcium risk stratification: agatston, volume, and mass scores in 11, 490 individuals. AJR Am J Roentgenol 181(3):743–748

    PubMed  Google Scholar 

  8. Callister TQ, Cooil B, Raya SP et al (1998) Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method. Radiology 208(3):807–814

    PubMed  CAS  Google Scholar 

  9. Hong C, Becker CR, Schoepf UJ et al (2002) Coronary artery calcium: absolute quantification in nonenhanced and contrast-enhanced multi-detector row CT studies. Radiology 223(2):474–480

    Article  PubMed  Google Scholar 

  10. Ohnesorge B, Flohr T, Becker C et al (2000) Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Radiology 217(2):564–571

    PubMed  CAS  Google Scholar 

  11. Oudkerk M, Stillman AE, Halliburton SS et al (2008) Coronary artery calcium screening: current status and recommendations from the European Society of Cardiac Radiology and North American Society for Cardiovascular Imaging. Eur Radiol 18(12):2785–2807

    Article  PubMed  Google Scholar 

  12. Genders TS, Pugliese F, Mollet NR et al (2010) Incremental value of the CT coronary calcium score for the prediction of coronary artery disease. Eur Radiol 20(10):2331–2340

    Article  PubMed  Google Scholar 

  13. Vliegenthart R, Song B, Hofman A et al (2003) Coronary calcification at electron-beam CT: effect of section thickness on calcium scoring in vitro and in vivo. Radiology 229(2):520–525

    Article  PubMed  Google Scholar 

  14. Begemann PG, van Stevendaal U, Koester R et al (2007) Evaluation of the influence of acquisition and reconstruction parameters for 16-row multidetector CT on coronary calcium scoring using a stationary and dynamic cardiac phantom. Eur Radiol 17(8):1985–1994

    Article  PubMed  Google Scholar 

  15. Ulzheimer S, Kalender WA (2003) Assessment of calcium scoring performance in cardiac computed tomography. Eur Radiol 13(3):484–497

    PubMed  Google Scholar 

  16. Detrano RC, Doherty TM, Xiang M et al (2004) Comparison of calcium scores from thick- and thin image slice-computed tomography scanning in predicting future coronary events. Am J Cardiol 93(5):624–626

    Article  PubMed  CAS  Google Scholar 

  17. Groen JM, Greuter MJ, Vliegenthart R et al (2008) Calcium scoring using 64-slice MDCT, dual source CT and EBT: a comparative phantom study. Int J Cardiovasc Imaging 24(5):547–556

    Article  PubMed  Google Scholar 

  18. van der Bijl N, Joemai RM, Geleijns J et al (2010) Assessment of Agatston coronary artery calcium score using contrast-enhanced CT coronary angiography. AJR Am J Roentgenol 195(6):1299–1305

    Article  PubMed  Google Scholar 

  19. Schlosser T, Hunold P, Schmermund A et al (2004) Coronary artery calcium score: influence of reconstruction interval at 16-detector row CT with retrospective electrocardiographic gating. Radiology 233(2):586–589

    Article  PubMed  Google Scholar 

  20. Jensen CJ, Jochims M, Eberle HC et al (2011) Coronary artery calcium score: influence of the reconstruction interval on cardiac risk stratification in asymptomatic patients using dual-source computed tomography. Rofo 183(3):233–237

    Article  PubMed  CAS  Google Scholar 

  21. Nelson JC, Kronmal RA, Carr JJ et al (2005) Measuring coronary calcium on CT images adjusted for attenuation differences. Radiology 235(2):403–414

    Article  PubMed  Google Scholar 

  22. Muhlenbruch G, Hohl C, Das M et al (2007) Evaluation of automated attenuation-based tube current adaptation for coronary calcium scoring in MDCT in a cohort of 262 patients. Eur Radiol 17(7):1850–1857

    Article  PubMed  Google Scholar 

  23. Nasir K, Raggi P, Rumberger JA et al (2004) Coronary artery calcium volume scores on electron beam tomography in 12, 936 asymptomatic adults. Am J Cardiol 93(9):1146–1149

    Article  PubMed  CAS  Google Scholar 

  24. Hokanson JE, MacKenzie T, Kinney G et al (2004) Evaluating changes in coronary artery calcium: an analytic method that accounts for interscan variability. AJR Am J Roentgenol 182(5):1327–1332

    PubMed  Google Scholar 

  25. Ferencik M, Ferullo A, Achenbach S et al (2003) Coronary calcium quantification using various calibration phantoms and scoring thresholds. Invest Radiol 38(9):559–566

    Article  PubMed  Google Scholar 

  26. Horiguchi J, Yamamoto H, Akiyama Y et al (2004) Coronary artery calcium scoring using 16-MDCT and a retrospective ECG-gating reconstruction algorithm. AJR Am J Roentgenol 183(1):103–108

    PubMed  Google Scholar 

  27. Raman R, Raman B, Napel S et al (2008) Semiautomated quantification of the mass and distribution of vascular calcification with multidetector CT: method and evaluation. Radiology 247(1):241–250

    Article  PubMed  Google Scholar 

  28. Yoon HC, Emerick AM, Hill JA et al (2002) Calcium begets calcium: progression of coronary artery calcification in asymptomatic subjects. Radiology 224(1):236–241

    Article  PubMed  Google Scholar 

  29. Brown ER, Kronmal RA, Bluemke DA et al (2008) Coronary calcium coverage score: determination, correlates, and predictive accuracy in the Multi-Ethnic Study of Atherosclerosis. Radiology 247(3):669–675

    Article  PubMed  Google Scholar 

  30. Kopp AF, Ohnesorge B, Becker C et al (2002) Reproducibility and accuracy of coronary calcium measurements with multi-detector row versus electron-beam CT. Radiology 225(1):113–119

    Article  PubMed  CAS  Google Scholar 

  31. Stanford W, Thompson BH, Burns TL et al (2004) Coronary artery calcium quantification at multi-detector row helical CT versus electron-beam CT. Radiology 230(2):397–402

    Article  PubMed  Google Scholar 

  32. van der Bijl N, de Bruin PW, Geleijns J et al (2010) Assessment of coronary artery calcium by using volumetric 320-row multi-detector computed tomography: comparison of 0.5 mm with 3.0 mm slice reconstructions. Int J Cardiovasc Imaging 26(4):473–482

    Google Scholar 

  33. Pan Z, Pang L, Li J et al (2011) Achieving consistent image quality with dose optimization in 64-row multidetector computed tomography prospective ECG gated coronary calcium scoring. Int J Cardiovasc Imaging 27(4):611–617

    Article  PubMed  Google Scholar 

  34. Horiguchi J, Matsuura N, Yamamoto H et al (2009) Effect of heart rate and body mass index on the interscan and interobserver variability of coronary artery calcium scoring at prospective ECG-triggered 64-slice CT. Korean J Radiol 10(4):340–346

    Article  PubMed  Google Scholar 

  35. Gilkeson RC, Novak RD, Sachs P (2004) Digital radiography with dual-energy subtraction: improved evaluation of cardiac calcification. AJR Am J Roentgenol 183(5):1233–1238

    PubMed  Google Scholar 

  36. Greenland P, LaBree L, Azen SP et al (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291(2):210–215

    Article  PubMed  CAS  Google Scholar 

  37. Mitchell GF, Hwang SJ, Vasan RS et al (2010) Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation 121(4):505–511

    Article  PubMed  Google Scholar 

  38. Polonsky TS, McClelland RL, Jorgensen NW et al (2010) Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 303(16):1610–1616

    Article  PubMed  CAS  Google Scholar 

  39. Rumberger JA, Simons DB, Fitzpatrick LA et al (1995) Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation 92(8):2157–2162

    PubMed  CAS  Google Scholar 

  40. Doherty TM, Detrano RC, Mautner SL et al (1999) Coronary calcium: the good, the bad, and the uncertain. Am Heart J 137(5):806–814

    Article  PubMed  CAS  Google Scholar 

  41. Rumberger JA (1999) Coronary artery calcification: “…empty your cup”. Am Heart J 137(5):774–776

    Article  PubMed  CAS  Google Scholar 

  42. Guerci AD, Spadaro LA, Popma JJ et al (1997) Relation of coronary calcium score by electron beam computed tomography to arteriographic findings in asymptomatic and symptomatic adults. Am J Cardiol 79(2):128–133

    Article  PubMed  CAS  Google Scholar 

  43. Rumberger JA, Sheedy PF, Breen JF et al (1997) Electron beam computed tomographic coronary calcium score cutpoints and severity of associated angiographic lumen stenosis. J Am Coll Cardiol 29(7):1542–1548

    Article  PubMed  CAS  Google Scholar 

  44. Moser KW, O’Keefe JH Jr, Bateman TM et al (2003) Coronary calcium screening in asymptomatic patients as a guide to risk factor modification and stress myocardial perfusion imaging. J Nucl Cardiol 10(6):590–598

    Article  PubMed  Google Scholar 

  45. Mendoza-Rodriguez V, Llerena LR, Rodriguez-de la Vega A et al (2010) Volume of coronary calcified plaques by computed tomography and presence of significant stenosis by coronary angiography. Arch Cardiol Mex 80(3):181–186

    PubMed  Google Scholar 

  46. Thilo C, Gebregziabher M, Mayer FB et al (2010) Correlation of regional distribution and morphological pattern of calcification at CT coronary artery calcium scoring with non-calcified plaque formation and stenosis. Eur Radiol 20(4):855–861

    Article  PubMed  Google Scholar 

  47. Detrano R, Hsiai T, Wang S et al (1996) Prognostic value of coronary calcification and angiographic stenoses in patients undergoing coronary angiography. J Am Coll Cardiol 27:285–290

    Article  PubMed  CAS  Google Scholar 

  48. Shaw LJ, Raggi P, Schisterman E et al (2003) Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 228(3):826–833

    Article  PubMed  Google Scholar 

  49. Brown BG, Morse J, Zhao XQ et al (2001) Electron-beam tomography coronary calcium scores are superior to Framingham risk variables for predicting the measured proximal stenosis burden. Am J Cardiol 88(2A):23E–26E

    PubMed  CAS  Google Scholar 

  50. Herzog C, Britten M, Balzer JO et al (2004) Multidetector-row cardiac CT: diagnostic value of calcium scoring and CT coronary angiography in patients with symptomatic, but atypical, chest pain. Eur Radiol 14(2):169–177

    Article  PubMed  Google Scholar 

  51. Cheng YJ, Church TS, Kimball TE et al (2003) Comparison of coronary artery calcium detected by electron beam tomography in patients with to those without symptomatic coronary heart disease. Am J Cardiol 92(5):498–503

    Article  PubMed  CAS  Google Scholar 

  52. Guerci AD, Spadaro LA, Goodman KJ et al (1998) Comparison of electron beam computed tomography scanning and conventional risk factor assessment for the prediction of angiographic coronary artery disease. J Am Coll Cardiol 32(3):673–679

    Article  PubMed  CAS  Google Scholar 

  53. Akram K, Voros S (2008) Absolute coronary artery calcium scores are superior to MESA percentile rank in predicting obstructive coronary artery disease. Int J Cardiovasc Imaging 24(7):743–749

    Article  PubMed  Google Scholar 

  54. McClelland RL, Chung H, Detrano R et al (2006) Distribution of coronary artery calcium by race, gender, and age: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 113(1):30–37

    Article  PubMed  Google Scholar 

  55. Patel MJ, de Lemos JA, McGuire DK et al (2009) Evaluation of coronary artery calcium screening strategies focused on risk categories: the Dallas Heart Study. Am Heart J 157(6):1001–1009

    Article  PubMed  CAS  Google Scholar 

  56. Wexler L, Brundage B, Crouse J et al (1996) Coronary artery calcification: pathophysiology, epidemiology, imaging methods, and clinical implications. A statement for health professionals from the American Heart Association. Writing Group. Circulation 94(5):1175–1192

    PubMed  CAS  Google Scholar 

  57. Shemesh J, Apter S, Itzchak Y et al (2003) Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT. Radiology 226(2):483–488

    Article  PubMed  Google Scholar 

  58. Thompson BH, Stanford W (2001) Imaging of coronary calcium: a case for electron beam computed tomography. J Thorac Imaging 16(1):8–15

    Article  PubMed  CAS  Google Scholar 

  59. Knez A, Becker A, Leber A et al (2004) Relation of coronary calcium scores by electron beam tomography to obstructive disease in 2, 115 symptomatic patients. Am J Cardiol 93(9):1150–1152

    Article  PubMed  CAS  Google Scholar 

  60. Ergun E, Kosar P, Ozturk C et al (2011) Prevalence and extent of coronary artery disease determined by 64-slice CTA in patients with zero coronary calcium score. Int J Cardiovasc Imaging 27(3):451–458

    Article  PubMed  Google Scholar 

  61. Kelly JL, Thickman D, Abramson SD et al (2008) Coronary CT angiography findings in patients without coronary calcification. AJR Am J Roentgenol 191(1):50–55

    Article  PubMed  Google Scholar 

  62. Schenker MP, Dorbala S, Hong EC et al (2008) Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease: a combined positron emission tomography/computed tomography study. Circulation 117(13):1693–1700

    Article  PubMed  Google Scholar 

  63. Uretsky S, Rozanski A, Singh P et al (2011) The presence, characterization and prognosis of coronary plaques among patients with zero coronary calcium scores. Int J Cardiovasc Imaging 27(6):805–812

    Article  PubMed  Google Scholar 

  64. Esteves FP, Khan A, Correia LC et al (2011) Absent coronary artery calcium excludes inducible myocardial ischemia on computed tomography/positron emission tomography. Int J Cardiol 147(3):424–427

    Article  PubMed  Google Scholar 

  65. Church TS, Levine BD, McGuire DK et al (2007) Coronary artery calcium score, risk factors, and incident coronary heart disease events. Atherosclerosis 190(1):224–231

    Article  PubMed  CAS  Google Scholar 

  66. van Werkhoven JM, de Boer SM, Schuijf JD et al (2010) Impact of clinical presentation and pretest likelihood on the relation between calcium score and computed tomographic coronary angiography. Am J Cardiol 106(12):1675–1679

    Article  PubMed  Google Scholar 

  67. Meng L, Cui L, Cheng Y et al (2009) Effect of heart rate and coronary calcification on the diagnostic accuracy of the dual-source CT coronary angiography in patients with suspected coronary artery disease. Korean J Radiol 10(4):347–354

    Article  PubMed  Google Scholar 

  68. Tsai IC, Choi BW, Chan C et al (2010) ASCI 2010 appropriateness criteria for cardiac computed tomography: a report of the Asian Society of Cardiovascular Imaging Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging Guideline Working Group. Int J Cardiovasc Imaging 26(Suppl 1):1–15

    Article  PubMed  Google Scholar 

  69. Taylor AJ, Cerqueira M, Hodgson JM et al (2010) ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol 56(22):1864–1894

  70. Bild DE, Detrano R, Peterson D et al (2005) Ethnic differences in coronary calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 111(10):1313–1320

    Article  PubMed  Google Scholar 

  71. Elias-Smale SE, Proenca RV, Koller MT et al (2010) Coronary calcium score improves classification of coronary heart disease risk in the elderly: the Rotterdam study. J Am Coll Cardiol 56(17):1407–1414

    Article  PubMed  Google Scholar 

  72. Sirineni GK, Raggi P, Shaw LJ et al (2008) Calculation of coronary age using calcium scores in multiple ethnicities. Int J Cardiovasc Imaging 24(1):107–111

    Article  PubMed  Google Scholar 

  73. Colletti PM, Dustin LD, Wong ND et al (2010) Does coronary calcium score predict future cardiac function? Association of subclinical atherosclerosis with left ventricular systolic and diastolic dysfunction at MR imaging in an elderly cohort. Radiology 257(1):64–70

    Article  PubMed  Google Scholar 

  74. Stolzmann P, Alkadhi H, Scheffel H et al (2010) Combining cardiac magnetic resonance and computed tomography coronary calcium scoring: added value for the assessment of morphological coronary disease? Int J Cardiovasc Imaging 27(7):969–977

    Article  PubMed  Google Scholar 

  75. Raggi P, Cooil B, Shaw LJ et al (2003) Progression of coronary calcium on serial electron beam tomographic scanning is greater in patients with future myocardial infarction. Am J Cardiol 92(7):827–829

    Article  PubMed  Google Scholar 

  76. Wong ND, Kawakubo M, LaBree L et al (2004) Relation of coronary calcium progression and control of lipids according to National Cholesterol Education Program guidelines. Am J Cardiol 94(4):431–436

    Article  PubMed  CAS  Google Scholar 

  77. Raggi P, Callister TQ, Shaw LJ (2004) Progression of coronary artery calcium and risk of first myocardial infarction in patients receiving cholesterol-lowering therapy. Arterioscler Thromb Vasc Biol 24(7):1272–1277

    Article  PubMed  CAS  Google Scholar 

  78. Chen LC, Chen JW, Wu MH et al (2001) Differential coronary calcification on electron-beam CT between syndrome X and coronary artery disease in patients with chronic stable angina pectoris. Chest 120(5):1525–1533

    Article  PubMed  CAS  Google Scholar 

  79. Haydar AA, Hujairi NM, Covic AA et al (2004) Coronary artery calcification is related to coronary atherosclerosis in chronic renal disease patients: a study comparing EBCT-generated coronary artery calcium scores and coronary angiography. Nephrol Dial Transplant 19(9):2307–2312

    Article  PubMed  Google Scholar 

  80. Kim CD, Cho JH, Choi HJ et al (2005) Coronary-artery calcium scores using electron beam CT in patients with chronic renal failure. J Korean Med Sci 20(6):994–999

    Article  PubMed  CAS  Google Scholar 

  81. Raggi P, Shaw LJ, Berman DS et al (2004) Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 43(9):1663–1669

    Article  PubMed  CAS  Google Scholar 

  82. Tong W, Lima JA, Lai H et al (2004) Relation of coronary artery calcium to left ventricular mass in African-Americans. Am J Cardiol 93(4):490–492

    Article  PubMed  CAS  Google Scholar 

  83. Pan NH, Yang HY, Hsieh MH et al (2008) Coronary calcium score from multislice computed tomography correlates with QT dispersion and left ventricular wall thickness. Heart Vessels 23(3):155–160

    Article  PubMed  Google Scholar 

  84. Wong ND, Sciammarella M, Arad Y et al (2003) Relation of thoracic aortic and aortic valve calcium to coronary artery calcium and risk assessment. Am J Cardiol 92(8):951–955

    Article  PubMed  CAS  Google Scholar 

  85. Hamirani YS, Nasir K, Blumenthal RS et al (2011) Relation of mitral annular calcium and coronary calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA]). Am J Cardiol 107(9):1291–1294

    Article  PubMed  CAS  Google Scholar 

  86. Yun CH, Lin TY, Wu YJ et al (2011) Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks. Eur J Radiol. doi:10.1016/j.ejrad.2011.01.035

  87. Sabour S, Grobbee DE, Prokop M et al (2011) Change in abdominal obesity and risk of coronary calcification. J Epidemiol Community Health 65(3):287–288

    Article  PubMed  Google Scholar 

  88. Jung DH, Lee YJ, Ahn HY et al (2010) Relationship of hepatic steatosis and alanine aminotransferase with coronary calcification. Clin Chem Lab Med 48(12):1829–1834

    Article  PubMed  CAS  Google Scholar 

  89. Sullivan JM, Vander Zwaag R, Lemp GF et al (1988) Postmenopausal estrogen use and coronary atherosclerosis. Ann Intern Med 108(3):358–363

    PubMed  CAS  Google Scholar 

  90. Barrett-Connor E, Laughlin GA (2005) Hormone therapy and coronary artery calcification in asymptomatic postmenopausal women: the Rancho Bernardo Study. Menopause 12(1):40–48

    Article  PubMed  Google Scholar 

  91. Yaman O, Gulpinar O, Hasan T et al (2008) Erectile dysfunction may predict coronary artery disease: relationship between coronary artery calcium scoring and erectile dysfunction severity. Int Urol Nephrol 40(1):117–123

    Article  PubMed  Google Scholar 

  92. Ross R (1999) Atherosclerosis–an inflammatory disease. N Engl J Med 340(2):115–126

    Article  PubMed  CAS  Google Scholar 

  93. Park BJ, Shim JY, Lee HR et al (2011) Relationship of neutrophil-lymphocyte ratio with arterial stiffness and coronary calcium score. Clin Chim Acta 412(11–12):925–929

    Article  PubMed  CAS  Google Scholar 

  94. Simon JA (1992) Vitamin C and cardiovascular disease: a review. J Am Coll Nutr 11(2):107–125

    PubMed  CAS  Google Scholar 

  95. Simon JA, Murtaugh MA, Gross MD et al (2004) Relation of ascorbic acid to coronary artery calcium: the Coronary Artery Risk Development in Young Adults Study. Am J Epidemiol 159(6):581–588

    Article  PubMed  Google Scholar 

  96. Kinney GL, Snell-Bergeon JK, Maahs DM et al (2011) Lipoprotein-associated phospholipase A activity predicts progression of subclinical coronary atherosclerosis. Diabetes Technol Ther 13(3):381–387

    Article  PubMed  CAS  Google Scholar 

  97. Cho JH, Jeong YH, Ahn YJ et al (2010) The impact of smoking on post-clopidogrel platelet reactivity in patients with acute myocardial infarction. Korean Circ J 40(3):119–124

    Article  PubMed  CAS  Google Scholar 

  98. Drosch T, Brodoefel H, Geisler T et al (2010) Plaque distribution in clopidogrel responders and low responders as determined by multislice computed tomography. Tex Heart Inst J 37(5):547–552

    PubMed  Google Scholar 

  99. Baker JF, Zhang L, Imadojemu S et al (2011) Circulating endothelial progenitor cells are reduced in SLE in the absence of coronary artery calcification. Rheumatol Int. doi:10.1007/s00296-010-1730-9

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Acknowledgments

“This research was supported by the MKE (The Ministry of Knowledge Economy), Korea, under the ITRC (Information Technology Research Center) support program supervised by the NIPA (National IT Industry Promotion Agency (NIPA-2011-(C1090-1121-0002)) and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010-000-7337).”

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  1. Department of Radiology, Kyungpook National University and Hospital, 50, Sam-Duk 2 Ga, Jung Gu, Daegu, 700-721, South Korea

    Jongmin Lee

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Lee, J. Coronary artery calcium scoring and its impact on the clinical practice in the era of multidetector CT. Int J Cardiovasc Imaging 27 (Suppl 1), 9–25 (2011). https://doi.org/10.1007/s10554-011-9964-5

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