  
Electron beam tomography may improve diagnosis of subclinical CAD in women
Last Updated: 2001-04-30 17:10:24 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - Electron beam tomography (EBT) may provide a better means of detecting subclinical coronary artery disease (CAD) in women than the use of National Cholesterol Education Program (NCEP) lipid guidelines.
In a study reported in the May issue of the Journal of the American College of Cardiology, Dr. Harvey S. Hecht, from the Arizona Heart Institute and Foundation in Phoenix, and Dr. H. Robert Superko, from Berkeley HeartLab in California, assessed lipid and EBT profiles in 304 asymptomatic self-referred women who were concerned about their CAD risk.
Women were classified as "NCEP higher risk" if the low density lipoprotein cholesterol (LDLC) level was 130 mg/dL or greater and/or the high density lipoprotein cholesterol (HDLC) level was less than 35 mg/dL. Women not meeting these parameters were classified as "NCEP lower risk." Women were classified as EBT+ if a calcified plaque was visualized, otherwise they were considered EBT-.
The researchers found that 42% and 58% of women were EBT+ and EBT-, respectively. NCEP higher and lower risk women accounted for 53.5% and 46.5%, respectively, of the EBT+ group, the authors state. The EBT- group was 37.7% NCEP higher risk women and 62.3% NCEP lower risk women.
Using EBT-identified calcified plaque as the definition of subclinical CAD, only 58.6% of all women would have been correctly diagnosed using NCEP guidelines. "This investigation, for the first time, defines the relationship between NCEP higher and lower risk lipid guidelines and subclinical atherosclerosis in asymptomatic women as determined by EBT," the researchers note.
"The underappreciated magnitude of CAD in women, far exceeding breast cancer, may warrant wider scale implementation of EBT in the asymptomatic population," Drs. Hecht and Superko conclude.
J Am Coll Cardiol 2001;37:1506-1511.
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