We propose to test the hypothesis that the long-term risk of coronary heart disease can be accurately predicted by the pressure of coronary calcific deposits, detected by screening with cardiac fluoroscopy. We will also evaluate whether this is a more sensitive method of screening (without loss of specificity) than is exercise testing. The two noninvasive tests chosen could easily be applied alone or together in a large-scale screening program and be used to test different aspects of the disease process (physiology versus anatomy). The utility of exercise testing for screening has been limited by its relatively low sensitivity since it can only detect atherosclerotic plaque large enough to significantly impede coronary flow. Sophisticated fluoroscopic techniques are more sensitive for detecting atherosclerotic plaque and probably for predicting coronary events as well. A single screen prospective epidemiological study involving both test will be conducted on 825 American veterans with at least a 15% Framingham risk probability of coronary heart disease which will be defined by the epidemiologic endpoints of medical history will be conducted at baseline, and subjects will be followed for six years with annual visits and contacts with the primary physicians to ascertain occurrence of coronary heart disease. The sensitivity and specificity of exercise testing and fluoroscopy in relation to the incidence of coronary heart disease will be determined and compared. The predictive utility of each test, relation to the six-year incidence of coronary events, independent of the other test and baseline risk factors, will be assessed by logistic analysis.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL043277-03
Application #
3361881
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1990-11-01
Project End
1995-09-29
Budget Start
1991-09-30
Budget End
1992-09-29
Support Year
3
Fiscal Year
1991
Total Cost
Indirect Cost
City
Torrance
State
CA
Country
United States
Zip Code
90502
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Detrano, R C; Wong, N D; Doherty, T M et al. (1999) Coronary calcium does not accurately predict near-term future coronary events in high-risk adults. Circulation 99:2633-8

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