Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor
In Reply: Dr Farzaneh-Far brings up the important
distinction between atherosclerotic intimal calcification and medial calcification.
Because calcified deposits in the arterial intima are more likely to lead
to vascular obstruction, he argues that intimal calcification might be more
strongly related to the risk of clinical cardiovascular events. Unfortunately,
we were unable to distinguish between intimal and medial calcification. The
radiographic films used in our study were read as part of a multiphasic health
screening between 1964 and 1973; the radiologists had been instructed to mark
the presence or absence of calcification of the aortic arch without furnishing
any additional information. Attempts to reread these films were deemed impractical
because of deterioration or difficulty in locating the original minifilms.
It should also be noted that intimal and medial calcification are not always
easy to distinguish by radiography, particularly when they coexist.
Iribarren C, Browner WS. Origins and Consequences of Vascular Calcification—Reply. JAMA. 2000;284(12):1515-1516. doi:10.1001/jama.284.12.1512