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Coronary atherosclerosis can induce stable angina pectoris due to gradual stenosis of coronary artery or induce acute coronary syndrome following abrupt rupture of atheromatous plaque and subsequent sudden cut-off of coronary blood flow. Of these, the abrupt rupture of the plaque is closely related to the character of the plaque rather than to the degree of stenosis of arterial lumen, and the prognosis of acute coronary syndrome is worse than stable angina. Thus the detection of nonobstructive coronary atherosclerosis is as important as the detection of obstructive lesion. Electron Beam Tomography can precisely quantitate the calcium of coronary artery, which is highly correlated with the total amount of coronary atherosclerosis. It has not ability to detect the atherosclerosis in early stage, though it is the most sensitive and non-invasive modality currently available to predict short-term prognosis of future cardiovascular events. It can screen out the advanced coronary atherosclerosis and thus can accurately predict the preclinical or silent coronary heart disease compared to any other traditional method. The accuracy of this test is influenced by the age of screenee, so the test is most helpful in 40 to 60 age group. The development of coronary atherosclerosis can be slowed down or reversed, or the incidence of fatal acute myocardial infacrtion can be reduced by aggressive risk factor modification to this high risk group. Also the follow-up study coronary artery calcium with or without risk factor modification can broaden the knowledge of the natural history of atherosclorosis in clinical practice.

The Role of Coronary Artery Calcium Score Study: for the Prevention and Reduction of Obstructive Coronary Arterial Disease