The Utility of EBCT Screening Vs Conventional Risk Factor Assessment in Post Menopausal Women Joan E Briller, Julie A Hoff, George T Kondos, Univ. of Illinois at Chicago, Chicago.

 Background:  Between 1993-1999, we examined the prevalence of CAC relative to the number of reported CAD risk factors in 4,084 post menopausal asymptomatic women mean age 59.2 + 7.0 yrs., self-referred for CAC screening by EBCT.

 Methods:    Individuals provided demographic and CAD risk factor information. The number of risk factors (chol, HTN, DM, family hx of CAD, cigarette use) reported by each woman was summed, and the total CAC score was categorized into two groups; 0-30 and >30 Hu.

 Results:    The more CAD risk factors reported, the greater the likelihood of having CAC scores >30 Hu. However, the presence of CAD risk factors did not predict all post menopausal women with CAC >30 Hu. In 2,039 women older than the median age of 58 years, 35% reported no CAD risk factors yet had CAC scores >30 Hu (see table). Even in 2,045 women <58 years old, 10.4% reported no risk factors despite a total calcium score >30 HU.

Risk Factors vs Total CAC Score  (>58 years)

                                                Risk factors                           0               1               2               >3

                                                        n                                   322            797           602            318

                                             Total CACS 0-30                   64.9%      64.1%       57.8%       53.1%

                                             Total CACS  >30                  35.1%      35.9%       42.2%        46.9%

 Conclusion:  Conventional CAD risk factor assessment alone overlooks women with evidence of subclinical CAD. CAC screening in addition to CAD risk factor assessment may better stratify CAD risk especially among older post menopausal women.

 

Coronary Calcification in Postmenopausal Women with Estrogen Substitution Alexander Becker, Christoph Becker, Andreas Knez, Alexander Leber, Rolan Bruening, Maximilian Reiser, Ralph Habert (Medical Hospital I, Department of Radiology, Univ. of Munich, Munich, Germany)

 Background  Coronary calcification has proven to be a highly sensitive marker for the risk of cardiovascular diseases.  We determined coronary calcification in 76 postmenopausal women (group 1) with estrogen substitution and compared the coronary calcium score determined by electron beam computed tomography with the scores of 76 postmenopausal women without estrogen substitution. In group 1, a substitution with estrogen 0.6 mg/d in combination with gestagen took place for at least the last 4 years

 Result In group 1 calcium score with 112 ± 78 was significantly lower than in group II with 182 ± 89, p <0.05.  In subgroups with hypertension and hypercholesteremia differences were even more significant with calcium score = 131 ± 42 respectively 179 ± 38 in group I and calcium score = 200 ± 42 respectively 283 ± 47 in group II, p <0.01.

 Conclusion Postmenopausal women with estrogen substitution show significant lower coronary calcifications as a risk factor for coronary artery disease.  Still further examinations in women with CAD and examinations over a longer period have to follow.