To the Editor: In their cohort study, Dr Polonsky and colleagues1 confirmed that coronary calcification is a significant predictor of cardiovascular events. However, several important questions remain unanswered.
The coronary artery calcium score (CACS) has a very poor ability to discriminate between those who will and those who will not experience a clinical cardiovascular event. In this study with a median of 5.8 years of follow-up, 122 acute cardiovascular events occurred among the 5878 participants (aged 45-84 years; mean age, 62 years). The majority of persons with coronary calcium will not experience a clinical event,2 and because approximately one-third of the middle-aged population and almost 100% of the older population have coronary calcification,3 the performance of a CACS test may cause unnecessary anxiety in the general population.
The importance of this issue could have been illuminated by presenting the mean CACS in persons with vs persons without cardiovascular events. It would be of interest if the authors could present the cardiovascular event rates in different person subgroups according to CACS (eg, 0, 1-100, 101-300, >300).
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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