chapter  11
12 Pages

Progression of Coronary Artery Calcium and its Pharmacologic Modification

ByAxel Schmermund, Raimund Erbel

Coronary artery calcium (CAC) is intimately associated

with coronary atherosclerosis. As outlined in detail in

chapters 8 to 10, CAC predicts the overall extent and sever-

ity of atherosclerotic plaque formation in the coronary arter-

ies, whether measured at autopsy1,2 or in the living patient

by using invasive coronary angiography3-6 or intravascular

ultrasound.7-8 It has also been demonstrated that patients

with more advanced CAC have more frequent and severe

stress-induced myocardial ischemia as determined by

single-photon emission computed tomography.9,10 Finally,

patients with greater amounts of CAC have consistently

been reported to carry an increased cardiovascular event

risk.11-13 All these relationships have been analyzed using

CAC measurements in a cross-sectional manner. Much less

is known about the progression of CAC over time.