Coronary artery calcium and the risk of infarction: a method in search for a role?

Ischemic heart disease is the leading cause of death in western countries and research on effective strategies to prevent this disease and to identify subjects at risk at an early stage are priorities for the health care system. The review by Ratti et al.1 published in this issue of the Journal presents the current evidence on the feasibility of using coronary artery calcification, measured by multislice axial computed tomography, as a screening instrument and to predict the risk of coronary atherosclerosis. The latest generation multislice spiral computed tomography instruments are able to carry out an entire scan during the brief period a patient holds his breath, allowing high resolution images of the heart to be obtained with minimal movement artefacts. This method is becoming used in cardiology not only for measuring calcium deposition, but also for monitoring patients undergoing revascularization procedures (after stent implantation or a bypass) and for studying the walls and chambers of the heart.