BMJ  2003;326:1045-1046 (17 May), doi:10.1136/bmj.326.7398.1045

Editorial

Finding the age of the patient's heart

Electron beam computed tomography detects early coronary atherosclerosis

The first 150 words of the full text of this article appear below.

Atherosclerosis is the leading cause of morbidity and mortality in industrialised nations, and its prevalence in developing countries is rising. In up to 70% of patients the initial manifestation of coronary artery disease is either myocardial infarction or sudden death.1 Studies comparing coronary angiography with intravascular ultrasound, the reference standard for detection of atherosclerotic disease, have shown that vascular remodelling accompanies the early stages of the development of atherosclerotic plaque, and luminal narrowing therefore often does not occur until a clinically significant amount of intimal plaque has been formed.2 About 70% of acute coronary syndromes occur from rupture of haemodynamically insignificant or non-obstructive coronary artery plaquesw1 in previously asymptomatic individuals. The need is growing to identify accurately asymptomatic patients with a sizeable burden of coronary atherosclerotic plaque for intensive treatment.

The inflammatory response, which also contributes to atherogenesis, results in calcium being deposited in the atherosclerotic plaque. Histopathological studies confirm . . . [Full text of this article]

D Vijay Anand, research registrar in cardiology

Northwick Park Hospital, Harrow HA1 3UJ

David Lipkin, consultant cardiologist

Royal Free Hospital, London NW3 2QG

Avijit Lahiri, honorary consultant cardiologist

Cardiac Imaging and Research Centre, Wellington Hospital, London NW8 9LE


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