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The incremental value of coronary artery calcium scores to myocardial single photon emission computer tomography in risk assessment

  • Advances in NonNuclear Imaging Technologies
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References

  1. Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS, et al. ACC/AHA 2002 guideline update for the management of patients with chronic stable angina—summary article: A report of the American college of cardiology/American heart association task force on practice guidelines (committee on the management of patients with chronic stable angina). Circulation 2003;107:149-58.

    Article  PubMed  Google Scholar 

  2. Bugiardini R, Manfrini O, Pizzi C, Fontana F, Morgagni G. Endothelial function predicts future development of coronary artery disease: A study of women with chest pain and normal coronary angiograms. Circulation 2004;109:2518-23.

    Article  PubMed  Google Scholar 

  3. Djaberi R, Roodt J, Schuijf JD, Rabelink TJ, de Koning EJ, Pereira AM, et al. Endothelial dysfunction in diabetic patients with abnormal myocardial perfusion in the absence of epicardial obstructive coronary artery disease. J Nucl Med 2009;50:1980-6.

    Article  PubMed  CAS  Google Scholar 

  4. Pirich C, Leber A, Knez A, Bengel FM, Nekolla SG, Haberl R, et al. Relation of coronary vasoreactivity and coronary calcification in asymptomatic subjects with a family history of premature coronary artery disease. Eur J Nucl Med Mol Imaging 2004;31:663-670 (Epub 2004 Jan 2022)

    Google Scholar 

  5. Hacker M, Jakobs T, Hack N, Nikolaou K, Becker C, von Ziegler F, et al. Sixty-four slice spiral CT angiography does not predict the functional relevance of coronary artery stenoses in patients with stable angina. Eur J Nucl Med Mol Imaging 2007;34:4-10.

    Article  PubMed  Google Scholar 

  6. Hayat SA, Dwivedi G, Jacobsen A, Lim TK, Kinsey C, Senior R. Effects of left bundle-branch block on cardiac structure, function, perfusion, and perfusion reserve: Implications for myocardial contrast echocardiography versus radionuclide perfusion imaging for the detection of coronary artery disease. Circulation 2008;117:1832-41.

    Article  PubMed  CAS  Google Scholar 

  7. Hoyer HX, Hacker M, Gross H, Weiss M, Tiling R. Improved septal perfusion after cardiac resynchronization therapy in a patient with left bundle branch block and severely reduced left ventricular ejection fraction. J Nucl Cardiol 2006;13:584-6.

    Article  PubMed  Google Scholar 

  8. Forster S, Weiss M, Haug A, Krotz M, Tiling R, Schober A, et al. Myocardial perfusion defects due to irregular wall motion detected by 99mtc-sestamibi gated spect in a patient with constrictive pericarditis. Nuklearmedizin 2007;46:N26-7.

    PubMed  CAS  Google Scholar 

  9. Sun SS, Shiau YC, Tsai SC, Lin CC, Kao A, Lee CC. The role of technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography (SPECT) in the detection of cardiovascular involvement in systemic lupus erythematosus patients with non-specific chest complaints. Rheumatology (Oxford) 2001;40:1106-11.

    Article  CAS  Google Scholar 

  10. Beller GA, Zaret BL. Contributions of nuclear cardiology to diagnosis and prognosis of patients with coronary artery disease. Circulation 2000;101:1465-78.

    PubMed  CAS  Google Scholar 

  11. Gibbons RS. American society of nuclear cardiology project on myocardial perfusion imaging: Measuring outcomes in response to emerging guidelines. J Nucl Cardiol 1996;3:436-42.

    Article  PubMed  CAS  Google Scholar 

  12. Iskandrian AS, Chae SC, Heo J, Stanberry CD, Wasserleben V, Cave V. Independent and incremental prognostic value of exercise single-photon emission computed tomographic (SPECT) thallium imaging in coronary artery disease. J Am Coll Cardiol 1993;22:665-70.

    Article  PubMed  CAS  Google Scholar 

  13. Adamu U, Knollmann D, Almutairi B, Alrawashdeh W, Deserno V, Vogt F, et al. Stress/rest myocardial perfusion scintigraphy in patients without significant coronary artery disease. J Nucl Cardiol 2010;17:38-44.

    Article  PubMed  Google Scholar 

  14. Gimelli A, Rossi G, Landi P, Marzullo P, Iervasi G, L’Abbate A, et al. Stress/rest myocardial perfusion abnormalities by gated spect: Still the best predictor of cardiac events in stable ischemic heart disease. J Nucl Med 2009;50:546-53.

    Article  PubMed  Google Scholar 

  15. Hacker M, Jakobs T, Matthiesen F, Vollmar C, Nikolaou K, Becker C, et al. Comparison of spiral multidetector CT angiography and myocardial perfusion imaging in the noninvasive detection of functionally relevant coronary artery lesions: First clinical experiences. J Nucl Med 2005;46:1294-300.

    PubMed  Google Scholar 

  16. Stary H. The sequence of cell and matrix changes in atherosclerotic lesions of coronary arteries in the first forty years of life. Eur Heart J 1990;11:3-19.

    PubMed  Google Scholar 

  17. Virmani R, Kolodgie FD, Burke AP, Frab A, Schwartz SM. Lessons from sudden coronary death A comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2000;20:1262-75.

    Article  PubMed  CAS  Google Scholar 

  18. Shemesh J, Stroh C, Tenenbaum A, Hod H, Boyko V, Fisman E, et al. Comparison of coronary calcium in stable angina pectoris and in first acute myocardial infarction utilizing double helical computerized tomography. Am J Cardiol 1998;81:271-5.

    Article  PubMed  CAS  Google Scholar 

  19. Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al. From vulnerable plaque to vulnerable patient: A call for new definitions and risk assessment strategies: Part i. Circulation 2003;108:1664-72.

    Article  PubMed  Google Scholar 

  20. Rumberger JA, Simons DB, Fitzpatrick LA, Sheedy PF, Schwartz RS. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area. A histopathologic correlative study. Circulation 1995;92:2157-62.

    PubMed  CAS  Google Scholar 

  21. Becker CR, Kleffel T, Crispin A, Knez A, Young J, Schoepf UJ, et al. Coronary artery calcium measurement: Agreement of multirow detector and electron beam CT. AJR Am J Roentgenol 2001;176:1295-8.

    PubMed  CAS  Google Scholar 

  22. Jakobs TF, Wintersperger BJ, Herzog P, Flohr T, Suess C, Knez A, et al. Ultra-low-dose coronary artery calcium screening using multislice CT with retrospective ecg gating. Eur Radiol 2003;13:1923-30.

    Article  PubMed  Google Scholar 

  23. Voros S, Rivera JJ, Berman DS, Blankstein R, Budoff MJ, Cury RC, et al. Guideline for minimizing radiation exposure during acquisition of coronary artery calcium scans with the use of multidetector computed tomography a report by the society for atherosclerosis imaging and prevention tomographic imaging and prevention councils in collaboration with the society of cardiovascular computed tomography. J Cardiovasc Comput Tomogr 2011;5:75-83.

    Article  PubMed  Google Scholar 

  24. Ohnesorge B, Flohr T, Fischbach R, Kopp AF, Knez A, Schroder S, et al. Reproducibility of coronary calcium quantification in repeat examinations with retrospectively ecg-gated multisection spiral CT. Eur Radiol 2002;12:1532-40.

    Article  PubMed  CAS  Google Scholar 

  25. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990;15:827-32.

    Article  PubMed  CAS  Google Scholar 

  26. Becker CR, Majeed A, Crispin A, Knez A, Schoepf UJ, Boekstegers P, et al. CT measurement of coronary calcium mass: Impact on global cardiac risk assessment. Eur Radiol 2005;15(1):96-101.

    Google Scholar 

  27. McCollough CH, Ulzheimer S, Halliburton SS, White RD, Kalender WA. A multi-scanner, multi-manufacturer, international standard for the quantification of coronary artery calcium using cardiac CT. Radiology 2003;229:630.

    Article  Google Scholar 

  28. McCollough CH, Ulzheimer S, Halliburton SS, Shanneik K, White RD, Kalender WA. Coronary artery calcium: A multi-institutional, multimanufacturer international standard for quantification at cardiac CT. Radiology 2007;243:527-38.

    Article  PubMed  Google Scholar 

  29. Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. Coronary calcification, coronary disease risk factors, c-reactive protein, and atherosclerotic cardiovascular disease events: The st Francis Heart Study. J Am Coll Cardiol 2005;46:158-65.

    Article  PubMed  CAS  Google Scholar 

  30. Kondos GT, Hoff JA, Sevrukov A, Daviglus ML, Garside DB, Devries SS, et al. Electron-beam tomography coronary artery calcium and cardiac events: A 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 2003;107:2571-6.

    Article  PubMed  Google Scholar 

  31. Raggi P, Callister TQ, Cooil B, He ZX, Lippolis NJ, Russo DJ, et al. Identification of patients at increased risk of first unheralded acute myocardial infarction by electron-beam computed tomography. Circulation 2000;101:850-5.

    PubMed  CAS  Google Scholar 

  32. Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 2003;228:826-33.

    Article  PubMed  Google Scholar 

  33. Taylor AJ, Bindeman J, Feuerstein I, Cao F, Brazaitis M, O’Malley PG. Coronary calcium independently predicts incident premature coronary heart disease over measured cardiovascular risk factors: Mean three-year outcomes in the prospective army coronary calcium (PACC) project. J Am Coll Cardiol 2005;46:807-14.

    Article  PubMed  CAS  Google Scholar 

  34. Wayhs R, Zelinger A, Raggi P. High coronary artery calcium scores pose an extremely elevated risk for hard events. J Am Coll Cardiol 2002;39:225-30.

    Article  PubMed  Google Scholar 

  35. Wong ND, Hsu JC, Detrano RC, Diamond G, Eisenberg H, Gardin JM. Coronary artery calcium evaluation by electron beam computed tomography and its relation to new cardiovascular events. Am J Cardiol 2000;86:495-8.

    Article  PubMed  CAS  Google Scholar 

  36. Becker A, Leber A, Becker C, Knez A. Predictive value of coronary calcifications for future cardiac events in asymptomatic individuals. Am Heart J 2008;155:154-60.

    Article  PubMed  Google Scholar 

  37. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-45.

    Article  PubMed  CAS  Google Scholar 

  38. Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, et al. Long-term prognosis associated with coronary calcification: Observations from a registry of 25, 253 patients. J Am Coll Cardiol 2007;49:1860-70.

    Article  PubMed  Google Scholar 

  39. Greenland P, Bonow RO, Brundage BH, Budoff MJ, Eisenberg MJ, Grundy SM, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: A report of the American college of cardiology foundation clinical expert consensus task force (ACCF/AHA writing committee to update the 2000 expert consensus document on electron beam computed tomography) developed in collaboration with the society of atherosclerosis imaging and prevention and the society of cardiovascular computed tomography. J Am Coll Cardiol 2007;49:378-402.

    Article  PubMed  Google Scholar 

  40. Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: Executive summary: A report of the American college of cardiology foundation/American heart association task force on practice guidelines. Circulation 2010;122:2748-64.

    Article  PubMed  Google Scholar 

  41. Sarwar A, Shaw LJ, Shapiro MD, Blankstein R, Hoffmann U, Cury RC, et al. Diagnostic and prognostic value of absence of coronary artery calcification. JACC Cardiovasc Imaging 2009;2:675-88.

    Article  PubMed  Google Scholar 

  42. Polonsky TS, McClelland RL, Jorgensen NW, Bild DE, Burke GL, Guerci AD, et al. Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 2010;303:1610-6.

    Article  PubMed  CAS  Google Scholar 

  43. Erbel R, Mohlenkamp S, Moebus S, Schmermund A, Lehmann N, Stang A, et al. Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: The heinz nixdorf recall study. J Am Coll Cardiol 2010;56:1397-406.

    Article  PubMed  Google Scholar 

  44. Raggi P, Shaw LJ, Berman DS, Callister TQ. Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 2004;43:1663-9.

    Article  PubMed  CAS  Google Scholar 

  45. Gottlieb I, Miller JM, Arbab-Zadeh A, Dewey M, Clouse ME, Sara L, et al. The absence of coronary calcification does not exclude obstructive coronary artery disease or the need for revascularization in patients referred for conventional coronary angiography. J Am Coll Cardiol 2010;55:627-34.

    Article  PubMed  CAS  Google Scholar 

  46. Arad Y, Spadaro LA, Goodman K, Lledo-Perez A, Sherman S, Lerner G, et al. Predictive value of electron beam computed tomography of the coronary arteries. 19-month follow-up of 1173 asymptomatic subjects. Circulation 1996;93:1951-3.

    PubMed  CAS  Google Scholar 

  47. Rozanski A, Gransar H, Shaw LJ, Kim J, Miranda-Peats L, Wong ND, et al. Impact of coronary artery calcium scanning on coronary risk factors and downstream testing the EISNER (early identification of subclinical atherosclerosis by noninvasive imaging research) prospective randomized trial. J Am Coll Cardiol 2011;57:1622-32.

    Article  PubMed  CAS  Google Scholar 

  48. Anand DV, Lim E, Hopkins D, Corder R, Shaw LJ, Sharp P, et al. Risk stratification in uncomplicated type 2 diabetes: Prospective evaluation of the combined use of coronary artery calcium imaging and selective myocardial perfusion scintigraphy. Eur Heart J 2006;27:713-21.

    Article  PubMed  Google Scholar 

  49. Berman DS, Wong ND, Gransar H, Miranda-Peats R, Dahlbeck J, Hayes SW, et al. Relationship between stress-induced myocardial ischemia and atherosclerosis measured by coronary calcium tomography. J Am Coll Cardiol 2004;44:923-30.

    Article  PubMed  CAS  Google Scholar 

  50. He ZX, Hedrick TD, Pratt CM, Verani MS, Aquino V, Roberts R, et al. Severity of coronary artery calcification by electron beam computed tomography predicts silent myocardial ischemia. Circulation 2000;101:244-51.

    PubMed  CAS  Google Scholar 

  51. Moser KW, O’Keefe JH Jr, Bateman TM, McGhie IA. Coronary calcium screening in asymptomatic patients as a guide to risk factor modification and stress myocardial perfusion imaging. J Nucl Cardiol 2003;10:590-8.

    Article  PubMed  Google Scholar 

  52. Chang SM, Nabi F, Xu J, Peterson LE, Achari A, Pratt CM, et al. The coronary artery calcium score and stress myocardial perfusion imaging provide independent and complementary prediction of cardiac risk. J Am Coll Cardiol 2009;54:1872-82.

    Article  PubMed  Google Scholar 

  53. Mahmarian JJ. Combining myocardial perfusion imaging with computed tomography for diagnosis of coronary artery disease. Curr Opin Cardiol 2007;22:413-21.

    Article  PubMed  Google Scholar 

  54. Perrone-Filardi P, Achenbach S, Mohlenkamp S, Reiner Z, Sambuceti G, Schuijf JD, et al. Cardiac computed tomography and myocardial perfusion scintigraphy for risk stratification in asymptomatic individuals without known cardiovascular disease: A position statement of the working group on nuclear cardiology and cardiac CT of the European society of cardiology. Eur Heart J 2010 [Epub ahead of print].

  55. Rozanski A, Gransar H, Wong ND, Shaw LJ, Miranda-Peats R, Hayes SW, et al. Use of coronary calcium scanning for predicting inducible myocardial ischemia: Influence of patients’ clinical presentation. J Nucl Cardiol 2007;14:669-79.

    Article  PubMed  Google Scholar 

  56. Uebleis C, Becker A, Griesshammer I, Cumming P, Becker C, Schmidt M, et al. Stable coronary artery disease: Prognostic value of myocardial perfusion SPECT in relation to coronary calcium scoring—long-term follow-up. Radiology 2009;252:682-90.

    Article  PubMed  Google Scholar 

  57. Schuijf JD, Wijns W, Jukema JW, Atsma DE, de Roos A, Lamb HJ, et al. Relationship between noninvasive coronary angiography with multi-slice computed tomography and myocardial perfusion imaging. J Am Coll Cardiol 2006;48:2508-14.

    Article  PubMed  Google Scholar 

  58. Thompson RC, McGhie AI, Moser KW, O’Keefe JH Jr, Stevens TL, House J, et al. Clinical utility of coronary calcium scoring after nonischemic myocardial perfusion imaging. J Nucl Cardiol 2005;12:392-400.

    Article  PubMed  Google Scholar 

  59. Schepis T, Gaemperli O, Koepfli P, Namdar M, Valenta I, Scheffel H, et al. Added value of coronary artery calcium score as an adjunct to gated SPECT for the evaluation of coronary artery disease in an intermediate-risk population. J Nucl Med 2007;48:1424-30.

    Article  PubMed  Google Scholar 

  60. Ramakrishna G, Miller TD, Breen JF, Araoz PA, Hodge DO, Gibbons RJ. Relationship and prognostic value of coronary artery calcification by electron beam computed tomography to stress-induced ischemia by single photon emission computed tomography. Am Heart J 2007;153:807-14.

    Article  PubMed  Google Scholar 

  61. Rozanski A, Gransar H, Wong ND, Shaw LJ, Miranda-Peats R, Polk D, et al. Clinical outcomes after both coronary calcium scanning and exercise myocardial perfusion scintigraphy. J Am Coll Cardiol 2007;49:1352-61.

    Article  PubMed  CAS  Google Scholar 

  62. Schenker MP, Dorbala S, Hong EC, Rybicki FJ, Hachamovitch R, Kwong RY, et al. 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 2008;117:1693-700.

    Article  PubMed  Google Scholar 

  63. Schepis T, Gaemperli O, Koepfli P, Ruegg C, Burger C, Leschka S, et al. Use of coronary calcium score scans from stand-alone multislice computed tomography for attenuation correction of myocardial perfusion SPECT. Eur J Nucl Med Mol Imaging 2007;34:11-9.

    Article  PubMed  Google Scholar 

  64. Einstein AJ, Johnson LL, Bokhari S, Son J, Thompson RC, Bateman TM, et al. Agreement of visual estimation of coronary artery calcium from low-dose CT attenuation correction scans in hybrid PET/CT and SPECT/CT with standard Agatston score. J Am Coll Cardiol 2010;56:1914-21.

    Article  PubMed  Google Scholar 

  65. Min JK, Lin FY, Gidseg DS, Weinsaft JW, Berman DS, Shaw LJ, et al. Determinants of coronary calcium conversion among patients with a normal coronary calcium scan: What is the “warranty period” for remaining normal? J Am Coll Cardiol 2010;55:1110-7.

    Article  PubMed  Google Scholar 

  66. Budoff MJ, Hokanson JE, Nasir K, Shaw LJ, Kinney GL, Chow D, et al. Progression of coronary artery calcium predicts all-cause mortality. JACC Cardiovasc Imaging 2010;3:1229-36.

    Article  PubMed  Google Scholar 

  67. Rosen BD, Fernandes V, McClelland RL, Carr JJ, Detrano R, Bluemke DA, et al. Relationship between baseline coronary calcium score and demonstration of coronary artery stenoses during follow-up mesa (multi-ethnic study of atherosclerosis). JACC Cardiovasc Imaging 2009;2:1175-83.

    Article  PubMed  Google Scholar 

  68. Askew JW, Miller TD, Araoz PA, Breen JF, Hodge DO, Gibbons RJ. Abnormal electron beam computed tomography results: The value of repeating myocardial perfusion single-photon emission computed tomography in the ongoing assessment of coronary artery disease. Mayo Clin Proc 2008;83:17-22.

    Article  PubMed  Google Scholar 

  69. Berman DS, Hachamovitch R, Shaw LJ, Friedman JD, Hayes SW, Thomson LE, et al. Roles of nuclear cardiology, cardiac computed tomography, and cardiac magnetic resonance: Noninvasive risk stratification and a conceptual framework for the selection of noninvasive imaging tests in patients with known or suspected coronary artery disease. J Nucl Med 2006;47(7):1107–18.

    PubMed  Google Scholar 

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Acknowledgment

We thank Dr Paul Cumming for critical revision of the manuscript.

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  1. Department of Nuclear Medicine, University of Munich, Ziemssenstr.1, 80336, Munich, Germany

    Marcus Hacker MD

  2. Institute of Clinical Radiology, University of Munich, Munich, Germany

    Christoph Becker MD

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Correspondence to Marcus Hacker MD.

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Hacker, M., Becker, C. The incremental value of coronary artery calcium scores to myocardial single photon emission computer tomography in risk assessment. J. Nucl. Cardiol. 18, 700–711 (2011). https://doi.org/10.1007/s12350-011-9384-x

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