The use of electron-beam computed tomography as a tool for primary prevention

Coronary artery disease (CAD) is the most common cause of death in the United States, and most acute CAD events occur unexpectedly in patients unaware of their condition. Consequently, attention has recently focused on the development of new technologies for the early detection of CAD, such as electron-beam computed tomography (EBCT). With EBCT imaging, the coronary artery tree is visualized noninvasively and vascular calcification, a marker of atherosclerotic disease, is easily detected and its extent quantified. Current research suggests that the presence of coronary artery calcification on a screening EBCT image provides relevant prognostic information for the development of future coronary events. Furthermore, preliminary evidence suggests that the use of EBCT to observe the progression of disease, as demonstrated by changes in the coronary calcium burden on sequential studies, is a viable and exciting new application. The Beyond Endorsed Lipid Lowering with EBCT Scanning (BELLES) trial will use EBCT to compare the effects of 12 months of treatment with aggressive or moderate statin therapy on the progression of coronary atherosclerosis.