RSS Feeds
Electron-Beam Computed Tomography for Evaluating Coronary Artery Disease
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
IN RESPONSE
I appreciate Dr. Raggi's and Dr. Shields's comments. Dr. Raggi points out that electron-beam CT is the most sensitive tool available for the detection of minimal, subclinical disease, given that vascular remodeling may make lesions undetectable on angiography. Although the sensitivity of electron-beam CT is greater than that of other methods for the detection of non-flow-limiting lesions, some of these lesions may nevertheless be missed. Thus, the benefit lies in identifying patients with any calcium in their coronary arteries; if calcium is present, high-risk lesions are very likely. I look forward to further outcome studies that document electron-beam CT-detected coronary artery calcium as an independent predictor of future coronary events. If regression in coronary artery calcium scores during therapy with lipid-lowering agents correlates with a decrease in coronary artery events, the evidence supporting use of electron-beam CT will be even stronger.
Dr. Shields regrets that no comparison was made between electron-beam CT and intracoronary ultrasonography. Because fewer studies have addressed this question than have studies comparing electron-beam CT with angiography, I focused on the latter. Although the role of intracoronary ultrasonography in patient management is not as clearly defined as that of angiography, ultrasonography can provide important information about atherosclerotic plaque. In patients who have acute coronary syndromes but do not have angiographically evident critical stenoses, a study of both techniques revealed an overall linear relation between segments with calcified plaque and segments with noncalcified plaque, with high patient variability [1].
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
