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Coronary Calcium Helps Predict Heart Disease Across Races

In whites, blacks, Hispanics and Chinese, doubling of score linked to at least 18 percent higher risk

WEDNESDAY, March 26 (HealthDay News) -- Coronary calcium score is strongly associated with incident coronary heart disease, with a similar predictive value among four racial and ethnic groups in the United States, according to research published in the March 27 issue of the New England Journal of Medicine.

Robert Detrano, M.D., Ph.D., of the University of California at Irvine, and colleagues analyzed data from 6,722 adults of white, black, Hispanic and Chinese backgrounds, with no clinical cardiovascular disease at entry. The researchers assessed the subjects' coronary calcium with computed tomographic scans and followed subjects for a median of 3.8 years.

Across these groups, a doubling of the coronary calcium score was associated with an 18 percent to 39 percent higher risk of any coronary event, the researchers report. Compared with someone with no coronary calcium, people with a score of 101 to 300 had a hazard ratio of a coronary event of 7.73.

"The Multi-Ethnic Study of Atherosclerosis (MESA) results confirm previous studies that showed that calcium scoring does predict events, as do other risk factors. But is this relatively small improvement in accuracy worth it?" write William S. Weintraub, M.D., of the Christiana Care Health System in Newark, Del., and George A. Diamond, M.D., of the Cedars-Sinai Medical Center in Los Angeles, in an accompanying editorial. "There are not sufficient data available to offer a robust assessment of cost-effectiveness…Thus, coronary calcium scoring remains an interesting technique for predicting events, in addition to the simple Framingham score. Nonetheless, the role of coronary calcium screening -- and of risk stratification in general, beyond the Framingham score -- remains unknown."

Several of the study's co-authors report financial relationships with pharmaceutical companies.

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