Novel Risk Factors

Coronary calcium. Another indication of subclinical coronary atherosclerosis is coronary calcium as detected by electron beam computed tomography (EBCT) or spiral CT. Amounts of coronary calcium correlate positively with coronary plaque burden. Therefore, a high coronary calcium score should carry predictive power for major coronary events. Several studies indicate that, in persons with multiple risk factors, a concomitantly high coronary calcium score places persons in the range of a CHD risk equivalent.

Carotid intimal medial thickening. One test in this category is carotid sonography used to measure intimal medial thickness (IMT) of the carotid arteries. The extent of carotid atherosclerosis correlates positively with the severity of coronary atherosclerosis. Furthermore, recent studies show that severity of IMT independently correlates with risk for major coronary events. Thus, measurement of carotid IMT theoretically could be used as an adjunct in CHD risk assessment.