Home| About us| Widget| login/register| For authors| For reviewers |Submit a paper
(close)

(Ctrl-click to select multiple journals)


How should we address you?

Your email address


 Yes, sign up now
 Sign up for general news too

Privacy Statement
 
 
 

Clinical Medicine: Cardiology

Synopsis: An open access, peer reviewed electronic journal that covers prevention, diagnosis and management of cardiovascular disorders.


Indexing: 6 major databases. Pubmed indexing for NIH-funded research.

Processing time: Decision in 2 weeks for 90% of papers.

Visibility: Most popular article read 1400+ times.

RSS

NEWS

TWITTER
View factor
for journal
67978


About this journal

ISSN: 1178-1165


Aims and scope:

Clinical Medicine: Cardiology is an international, open access, peer reviewed journal which considers manuscripts on the prevention, diagnosis and management of cardiovascular disorders, in addition to related genetic, pathophysiological and epidemiological topics.

Editorial standards and procedures:

Submissions, excluding editorials, letters to the editor and dedications, will be peer reviewed by two reviewers.  Reviewers are required to provide fair, balanced and constructive reports.  

Under our Fairness in Peer Review Policy authors may appeal against reviewers' recommendations which are ill-founded, unobjective or unfair.  Appeals are considered by the Editor in Chief or Associate Editor.

Papers are not sent to peer reviewers following submission of a revised manuscript. Editorial decisions on re-submitted papers are based on the author's response to the initial peer review report.

Indexing:

This journal is indexed by the following services:

  • Google Scholar
  • CAS
  • DOAJ
  • SCOPUS
  • Embase
  • OAIster

SPARC Europe Seal award winner:

This journal has been awarded a SPARC Europe Seal. The Seal is an initiative of SPARC Europe (Scholarly Publishing and Academic Resources Coalition) and the Directory of Open Access Journals (DOAJ) which is awarded to journals applying a Creative Commons CC-BY copyright license and that make journal metadata accessible to DOAJ.  

Amongst other important services DOAJ makes metadata OAI-compliant.  This in turn enhances the visibility of papers and allows OAI-harvesters to include the details of journal articles in their services. We encourage readers to make use of this valuable resource.  The DOAJ search page is available here.

National Institutes of Health Public Access Policy compliant:

As of April 7 2008, the US NIH Public Access Policy requires that all peer reviewed articles resulting from research carried out with NIH funding be deposited in the Pubmed Central archive.

If you are an NIH employee or grantee Libertas Academica will ensure that you comply with the policy by depositing your paper at Pubmed Central on your behalf. 



 
 
 


Therapeutic Implications of Coronary Artery Calcium Using Cardiac Computed Tomography

Authors: Adonis Saremi and Rohit Arora
Publication Date: 16 Oct 2007
Clinical Medicine: Cardiology 2007:1 13-23

Adonis Saremi and Rohit Arora

Department of Medicine, Chicago Medical School, North Chicago, IL.

Abstract: The objective of this document is to review the clinical applicability of coronary artery calcium (CAC) scoring in both asymptomatic and symptomatic patients at risk for cardiovascular disease. We begin by describing the pathological basis of atherosclerosis, the characteristic stages of atherosclerotic plaque development, and the mechanism and role of arterial calcification in advanced atherosclerotic lesions. We also explain the utility of CAC scoring in cardiovascular risk assessment, discuss the most current clinical methods for measuring CAC, and examine major clinical studies reporting CAC scores in both asymptomatic and symptomatic heart patients. Lastly, the current recommendations for CAC scoring as stated by the American College of Cardiology/American Heart Association (ACC/AHA) are outlined, and a number of considerations for future research are provided. Atherosclerosis begins when certain factors cause chronic endothelial injury, which eventually leads to the build up of fi brofatty plaques in the intima of arterial blood vessels. In time, blood vessel walls can weaken, thrombi can form and plaques can send emboli to distal sites. There are six characteristic stages of plaque development. Mature plaques may be calcified in an active process comparable to bone remodeling, where calcium phosphate crystals coalesce among lipid particles inside arterial walls. Calcification is only present in atherosclerotic arteries, and the site and levels of calcium are non-linearly and positively associated with luminal narrowing of coronary vessels. Calcification is also postulated to stabilize vulnerable plaques in atherosclerotic vessels. Recent studies have shown that CAC scoring can improve the management of both asymptomatic and symptomatic heart patients. Electron beam computed tomography (EBCT) and Multidetector computed tomography (MDCT) are two fast cardiac CT methods used to measure CAC. No matter what technique one uses, CAC is scored with either the Agatston or the “volume” score system. The ACC/AHA currently finds it is reasonable for asymptomatic patients with intermediate Framingham risk scores (FRS) to undergo CAC assessment because these patients can be re-stratified into the high risk category if their CAC scores are 400. Conversely, CAC measurement in asymptomatic patients with low or high FRS is not warranted. There is also no evidence to suggest that high risk asymptomatic patients with no detectable coronary calcium should not be treated with secondary prevention medical therapy. For symptomatic patients, the ACC/AHA recommends CAC assessment as a second line technique to diagnose obstructive CAD, or when primary testing modalities are not possible or are unclear. Furthermore, they do not recommend the use of CAC measurement to determine the etiology of cardiomyopathy, to help identify patients with acute MI in the emergency room, or to assess the progression or regression of coronary atherosclerosis. Future research needs to incorporate calcium scores with percentile rankings, larger population samples, more women with at least intermediate Framingham risk, sufficient numbers of non-Caucasians, reports on cost-effectiveness, and data on populations with Chronic Kidney Disease, End Stage Renal Disease and Diabetes.



Post comment




No comments yet...Be the first to comment.

Bookmark this article

LINKEDIN FACEBOOK

Add to Mixx! MIXX YAHOO! BUZZ

PERMALINK DIGG


Sign up for free journal updates

How should we address you?
Your email address
 Yes, sign up now


Recently published in this journal

Assessment of Myocardial Scar; Comparison Between 18F-FDG PET, CMR and 99Tc-Sestamibi
- 08/Jun/2009

Circulating CD34+ Cell Count is Associated with Extent of Subclinical Atherosclerosis in Asymptomatic Amish Men, Independent of 10-Year Framingham Risk
- 27/May/2009

Improvement of Young and Elderly Patient’s Knowledge of Heart Failure After an Educational Session
- 20/Apr/2009

Platypnea-Orthodeoxia Syndrome in Two Previously Healthy Adults: A Case-based Review
- 09/Apr/2009

The Threshold of Admission Glycemia as a Predictor of Adverse Events in Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome
- 01/Apr/2009

Age-Related Alteration of Risk Profile, Inflammatory Response, and Angiographic Findings in Patients with Acute Coronary Syndrome
- 18/Feb/2009

Initial Cardiac Rhythm Correlated to Emergency Department Survival
- 09/Feb/2009

Factors Influencing Response to Cardiac Resynchronization Therapy in Patients with Heart Failure (Provisional PDF)
- 20/Jan/2009

Relationship Between the Plasma Concentration of C-Reactive Protein and Severity of Peripheral Arterial Disease
- 23/Dec/2008

The Effect of Chronic Anti-Hypertensive Therapy with Bendroflumethiazide on Sympathetic Drive
- 04/Nov/2008

Time to Medical Management in Patients Presenting with Non-ST Elevation Myocardial Infarction: A Retrospective Analysis of Two Teaching Hospitals
- 19/Sep/2008

Orthostatic Hypotension and Autonomic Failure: A Concise Guide to Diagnosis and Management
- 18/Sep/2008

Heat Shock Proteins in Cardiovascular Stress
- 07/Aug/2008

Exercise-Echocardiography–Derived Pulmonary Artery Pressure Slope in Borderline and Mild to Moderate Pulmonary Arterial Hypertension
- 08/Jul/2008

Fever and Peripheral Emboli in an Immunocompetent Host. A Case of Aspergillus Endocarditis
- 02/Jul/2008

Effect of Oxidative Stress on the Status of Adhesion Molecules, Nuclear Receptors and Cholesterol Flux in Endothelial Cells: Priming of Monocytes
- 17/Jun/2008

Knowledge of “Heart Attack” Symptoms in a Canadian Urban Community
- 21/May/2008

Treatment of Coronary Spastic Angina, Particularly Medically Refractory Coronary Spasm
- 14/May/2008

Cyclooxygenase-2 in Cardiovascular Biology
- 14/May/2008

Proteomic Analysis of Circulating Monocytes Identifies Cathepsin D as A Potential Novel Plasma Marker of Acute Coronary Syndromes
- 14/May/2008

Comparison of Invasive vs Noninvasive Pulse Wave Indices in Detection of Significant Coronary Artery Disease: Can We Use Noninvasive Pulse Wave Indices as Screening Test
- 01/May/2008

Nanoparticles as contrast agents for MRI of atherosclerotic lesions
- 22/Apr/2008

Outcome of Infective Endocarditis: Improved Results Over 18 Years (1990–2007)
- 22/Apr/2008

Periodontitis and Calculated Risk of Cardiovascular Mortality
- 18/Apr/2008

Cellular Therapy for Cardiovascular Disease Part 1 – Preclinical Insights
- 18/Apr/2008

Cellular Therapy for Cardiovascular Disease Part 2 – Delivery of Cells and Clinical Experience
- 18/Apr/2008

Long-Term Clinical Outcome after Sirolimus-Stent Implantation for in Sirolimus-Eluting Stent Restenosis
- 16/Apr/2008

The Diagnostic Value of B Natriuretic Peptide in Elderly Patients with Acute Dyspnea
- 27/Mar/2008

5-Fluorouracil-Induced Chest Pain and ST-Segment Elevation
- 26/Mar/2008

The Pulsed Doppler Predictors of Intra Dialysis Hypotension and Relationship between Doppler Indices and Net Fluid Loss after Dialysis in Patients with End Stage Renal Disease: Pulsed Doppler Study
- 26/Mar/2008

Methods for Detection of Matrix Metalloproteinases as Biomarkers in Cardiovascular Disease
- 17/Mar/2008

DNA Micro-Array Gene Expression Profi ling of Angiogenesis in Collagen Gel Culture
- 01/Mar/2008

Echocardiographic Improvements with Pacemaker Optimization in the Chronic Post Cardiac Resynchronization Therapy Setting
- 29/Feb/2008

Cardiac Surgery in Patients with Drug Eluting Stents:The Risk of Stopping Clopidogrel
- 09/Feb/2008

Coronary CT Angiography Findings in Patients with Ambiguous Left Main Coronary Artery Disease
- 09/Feb/2008

Methods for Handling Inter-Hospital Transfer in acute Myocardial Infarction Research
- 09/Feb/2008

Cardiovascular Risk Reduction in Diabetes in Sub-Saharan Africa: What should the Priorities be in the Absence of Global Risk Evaluation Tools?
- 09/Feb/2008

Contrast-Enhanced Cardiac Magnetic Resonance Imaging Accurately Differentiates Ischemic from Non-Ischemic Etiologies in Newly Diagnosed Cardiomyopathy
- 09/Feb/2008

Peripheral Arterial Disease Evaluation in the Saudi Project for Assessment of Coronary Events Registry Reveals a Missed Opportunity in Preventing the Adverse Cardiovascular Outcomes: A Pilot Study (SPACE-PAD-I)
- 09/Feb/2008

Arterial Stiffening is Associated with Exercise Intolerance and Hyperventilatory Response in Patients with Coronary Artery Disease
- 09/Feb/2008

Assessment of Fetal Autonomic Nervous System Activity by Fetal Magnetocardiography
- 09/Feb/2008

Late Intervention on an Occluded Infarct-Related Artery: A Meta-analysis of The Randomized Controlled Trials
- 13/Dec/2007

Implantation of an Endovenous Pacemaker in a Patient with Parkinson’s Disease and Bilateral Deep Brain Stimulators
- 11/Dec/2007

Therapeutic Implications of Coronary Artery Calcium Using Cardiac Computed Tomography
- 16/Oct/2007

Cilnidipine and Telmisartan Similarly Improves Vascular Damage in Hypertensive Patients
- 26/Sep/2007



Related journals...