Coronary artery calcification and its progression as a marker of asymptomatic coronary atherosclerosis

Coronary artery disease (CAD) events are the leading cause of mortality in the U.S. Coronary atherosclerosis, which leads to CAD events, can exist without clinical symptoms and asymptomatic disease does not necessarily infer mild disease. The detection of asymptomatic coronary atherosclerosis would be invaluable to elucidate its natural history and develop CAD interventions. Studies have been limited by lack of non-invasive measures of coronary atherosclerosis. Coronary artery calcification (CAC), a component of atherosclerosis, can now be measured non-invasively by electron beam computed tomography (CT).;Electron beam CT measures were used to study quantity of CAC and its progression as a marker of asymptomatic coronary atherosclerosis among individuals recruited from a community. Data included a baseline exam on 740 participants and baseline and 3.4 year follow-up exams on 78 participants. The goals were to: (1) examine the relationships between established CAD risk factors and quantity of CAC in three arteries using generalized linear mixed models, and estimate the variability in quantity of CAC explained by established CAD risk factors and the within-participant variability; (2) describe change in quantity of CAC over time; and (3) determine if being male, baseline age, and baseline cholesterol/high density lipoprotein cholesterol are associated with change in quantity of CAC over time.;The major findings were: (1) sex, arterial location, age, body size, blood pressure, measures of lipid metabolism, and smoking were significantly (p ;The findings provide evidence that electron beam CT's measures of quantity of CAC may be useful for in vivo studies of new, as yet unmeasured, risk factors for asymptomatic coronary atherosclerosis and of the natural history of CAC over time.