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September 27, 2000

Origins and Consequences of Vascular Calcification—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(12):1515-1516. doi:10.1001/jama.284.12.1512

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.

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