Anthony S. Fiorino, MD, PhD
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Fiorino A.; Electron-Beam Computed Tomography for Evaluating Coronary Artery Disease. Ann Intern Med. 1998;129:1077. doi: 10.7326/0003-4819-129-12-199812150-00026
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Published: Ann Intern Med. 1998;129(12):1077.
I appreciate Dr. Raggi's and Dr. Shields's comments. Dr. Raggi points out that electron-beam CT is the most sensitive tool available for the detection of minimal, subclinical disease, given that vascular remodeling may make lesions undetectable on angiography. Although the sensitivity of electron-beam CT is greater than that of other methods for the detection of non-flow-limiting lesions, some of these lesions may nevertheless be missed. Thus, the benefit lies in identifying patients with any calcium in their coronary arteries; if calcium is present, high-risk lesions are very likely. I look forward to further outcome studies that document electron-beam CT-detected coronary artery calcium as an independent predictor of future coronary events. If regression in coronary artery calcium scores during therapy with lipid-lowering agents correlates with a decrease in coronary artery events, the evidence supporting use of electron-beam CT will be even stronger.
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