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Accelerated Progression of Coronary Calcification: Four-year Follow-up in Patients with Stable Coronary Artery Disease¹

¹ From the Grace Ballas Research Unit of the Cardiac Rehabilitation Institute (J.S., M.M.) and Department of Diagnostic Imaging (S.A., J.R., Y.I.), Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer 52621, Israel; Division of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Hashomer, Israel (N.K.M.); and SOCAR Research Societe Anonyme, Nyon, Switzerland (B.A.K.). Received April 30, 2003; revision requested July 10; final revision received December 29; accepted January 30, 2004. Supported by a grant from Bayer, Leverkusen, Germany. Address correspondence to J.S. (e-mail: dshemesh@netvision.net.il).

View larger version (16K): [in a new window]   Figure 1. Graph shows median levels of TCS in quartiles (Q1-Q4) of baseline TCS. Significant progression (P < .001) is demonstrated for each quartile.

View larger version (15K): [in a new window]   Figure 2. Graph shows median levels of TCS for men and women. Progression of TCS is significant for both sexes (P < .001).

View larger version (28K): [in a new window]   Figure 3a. Graphs, which are similar, show continuous progression of TCS during 4 years of follow-up. (a) Graph shows the slope of the predicted line of natural logarithm of TCS after 2 years based on natural logarithm of baseline TCS (b = .91, P < .001). (b) Graph shows the slope of natural logarithm of TCS after 4 years based on natural logarithm of TCS after 2 years (b = .89, P < .001).

View larger version (32K): [in a new window]   Figure 3b. Graphs, which are similar, show continuous progression of TCS during 4 years of follow-up. (a) Graph shows the slope of the predicted line of natural logarithm of TCS after 2 years based on natural logarithm of baseline TCS (b = .91, P < .001). (b) Graph shows the slope of natural logarithm of TCS after 4 years based on natural logarithm of TCS after 2 years (b = .89, P < .001).

View larger version (109K): [in a new window]   Figure 4a. Transverse CT images show progression of CAC with confluence of small lesions. (a) Image with initial vessel calcium score of 82 for left anterior descending artery (LAD). (b) Image with vessel calcium score increased to 370 after 4 years. Note a new calcific lesion in the left circumflex artery (LCX). Calcifications are highlighted in gray to delineate their borders. Diagonal = diagonal branch.

View larger version (112K): [in a new window]   Figure 4b. Transverse CT images show progression of CAC with confluence of small lesions. (a) Image with initial vessel calcium score of 82 for left anterior descending artery (LAD). (b) Image with vessel calcium score increased to 370 after 4 years. Note a new calcific lesion in the left circumflex artery (LCX). Calcifications are highlighted in gray to delineate their borders. Diagonal = diagonal branch.

View larger version (94K): [in a new window]   Figure 5a. Transverse CT images show progression of CAC with volume increase of existing lesion. (a) Image with initial vessel calcium score of 562 for left anterior descending artery (LAD). (b) Image of same lesion in same artery 4 years later with vessel calcium score of 985. Calcifications are highlighted in gray to delineate their borders.

View larger version (90K): [in a new window]   Figure 5b. Transverse CT images show progression of CAC with volume increase of existing lesion. (a) Image with initial vessel calcium score of 562 for left anterior descending artery (LAD). (b) Image of same lesion in same artery 4 years later with vessel calcium score of 985. Calcifications are highlighted in gray to delineate their borders.