Raggi P
Tulane University School of Medicine, New Orleans, Louisiana 70112, USA.
Am J Cardiol. 2001 Feb 16;87(4A):27A-34A. doi: 10.1016/s0002-9149(01)01422-9.
Although currently recognized risk factors for coronary artery disease are helpful to predict the development of atherosclerosis, their ability to identify individual patients at risk of events is limited. Therefore, surrogate markers are being investigated to identify disease in its early phases in an attempt to decrease cardiovascular morbidity and mortality. Coronary artery calcification is a useful surrogate marker of coronary artery disease, and it can be visualized and measured noninvasively by means of electron beam tomography (EBT) imaging. Atherosclerosis starts to infiltrate the arterial intima layer much before luminal stenosis develops. Calcium is present in the large majority of mature atherosclerotic plaques, although, in rare cases, it may be absent. Recent research indicates that in selected patient subsets, coronary calcium may add incremental prognostic value to conventional risk factors for coronary artery disease and should therefore be used in association with such factors. EBT imaging for detection of arterial calcification is best employed in asymptomatic individuals at intermediate risk of coronary artery disease, symptomatic patients at low risk of coronary artery disease, and to track disease progression.
虽然目前公认的冠状动脉疾病风险因素有助于预测动脉粥样硬化的发展，但其识别有事件风险个体患者的能力有限。因此，正在研究替代标志物以在疾病早期阶段识别疾病，试图降低心血管发病率和死亡率。冠状动脉钙化是冠状动脉疾病的一种有用替代标志物，并且可以通过电子束断层扫描（EBT）成像进行无创可视化和测量。在管腔狭窄出现之前很久，动脉粥样硬化就开始浸润动脉内膜层。钙存在于绝大多数成熟的动脉粥样硬化斑块中，不过在极少数情况下可能不存在。最近的研究表明，在特定患者亚组中，冠状动脉钙化可能为冠状动脉疾病的传统风险因素增加额外的预后价值，因此应与这些因素联合使用。用于检测动脉钙化的EBT成像最适用于冠状动脉疾病中度风险的无症状个体、冠状动脉疾病低风险的有症状患者以及追踪疾病进展。
