Coronary artery calcification has been shown to play an important role in the development of atherosclerosis and is strongly associated with the total plaque burden proved in previous histopathologic studies. The use of electron beam CT (EBCT) for accurate quantitative measurements has led to an increased interest in understanding the clinical importance of coronary calcium. The coronary calcium score (CCS) determined by EBCT could provide useful prognostic information regarding subsequent coronary events in high-risk subjects with no clinical coronary artery disease (CAD), as well as in patients with the presence of CAD.> EBCT has also been demonstrated to be a useful technique for assessing the progression or regression of CAD in response to treatment of cardiovascular risk factors.
Endothelial dysfunction is thought to be an early sign of vascular endothelium injury and is the first critical step in the pathogenesis of atherosclerosis. Endothelial function plays a key role in determining the clinical manifestations of established atherosclerotic lesions and was proved predictive of further cardiovascular events.’ However, no previous study has shown the relationship between the extent of coronary artery calcification and endothelial function. Therefore, in this study we test the hypothesis that enhanced CCSs determined by EBCT would be associated with endothelial dysfunction assessed by brachial ultrasonography. In addition, although conflicting results were shown about the relationship between C-reactive protein (CRP) and coronary calcification in asymptomatic patients, in this study the associations of CRP and monocyte che-moattractant protein-1 (MCP-1) with coronary calcification and endothelial function were also evaluated in patients with suspected CAD.