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- W2075721293 abstract "E beam computed tomography (EBCT) non-invasively detects coronary artery disease (CAD) and tracks its progression, according to reports in last week’s New England Journal of Medicine. “The promise is two-fold”, says Tracy Callister (Electron Beam Tomography Research Foundation, Hendersonville, TN, USA). EBCT could be used as a “cheaper and noninvasive” alternative to angiograms for assessing treatment efficacy in CAD drug trials, and to monitor the effects of “aggressive prevention” strategies in patients at risk for CAD. Callister and co-workers retrospectively studied 149 patients who underwent two EBCT scans, 12–15 months apart; 105 patients were being treated with lipid-lowering drugs and 44 were not. Untreated patients showed significant increases in calcium volume in the second scan, and only treated patients who had low-density-lipoprotein concentrations of less than 3·1 mmol/L showed a net reduction in calcium volume. “The bottom line is, it looks like this tool can be used to track disease”, says Callister. Separately, German researchers used EBCT to detect coronary artery stenosis and occlusions in patients after intravenous injection of a contrast agent. 25% of 500 images were unusable because of “technical problems”, and no vessels could be evaluated in 15% of patients. But in evaluable patients, EBCT compared favorably with angiography (N Engl J Med 1998; 339: 1964–71, 1972–8). “The pictures are remarkably good, but you can’t always get the image or area you want”, notes Callister, whose group reported similar findings for EBCT angiography at the recent American Heart Association meeting. For example, scans are limited to the proximal coronary arteries, and patients who are overweight or move between scans are not good candidates. Other obstacles must also be overcome. “Until recently, we’ve had tools that only found disease very late, and now we’re jumping to tools that show disease so early, it’s hard to know who to screen when, and what to do if small amounts of calcification are detected”, observes Callister. An editorial warns that before EBCT can be used routinely for CAD screening, studies are needed to define calcium’s role in plaque progression and the impact of EBCT scanning on clinical outcomes. Such studies are underway, says Callister, and preliminary results are expected in 1–2 years." @default.
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- W2075721293 title "Non-invasive technique keeps track of coronary artery disease" @default.
- W2075721293 doi "https://doi.org/10.1016/s0140-6736(05)76165-1" @default.
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