Abstract 12310: Comparison of Coronary Artery Calcium Quantification Methods in Statin Users and Non-Users

Abstract

Background: Coronary artery calcium (CAC) can be quantified using various methods. The Agatston score (AS) computes the weighted sum of lesions with the maximum plaque attenuation factor. Calcium Volume measures the total volume of CAC, whereas Calcium Density has been shown to provide superior prognostication compared to the AS. Since statin use is associated with change in coronary plaque composition and thus CAC, we evaluated the difference CAC quantification methods among patients with suspected CAD receiving and not receiving statin therapy. Methods: Patients with suspected CAD and underwent cardiac computed tomography were recruited from a tertiary hospital in Singapore. Patient demographics and risk factors were obtained from electronic medical records. AS, Calcium Volume, Number of Lesions and Calcium Density were individually analysed with patient demographics and risk factors using multivariate models. Results were compared between patients on statins and not on statins to assess differences in CAC quantification methods. Results: Of the 528 patients, 43.0% were female, 40.9% had hypertension, 14.8% had diabetes, 44.3% had family history of CAD and 23.5% were smokers. While 58.5% of patients had hyperlipidemia, only 48.9% were on statin therapy. The mean age was 53.9±10.9 years, and the mean BMI was 26.1±5.69. Diabetes, hypertension, family history of CAD, and older age was more likely present in statin users (P < 0.05 for all). In multivariate analysis, these variables and higher BMI were significantly associated with statin use in all four models (Table 1). For CAC quantification, Calcium Volume, AS, and Number of Lesions did not differ significantly between statin users and non-users, whereas Calcium Density was higher in statin users (OR = 1.19, CI = (1.02, 1.39), P = 0.025). Conclusions: Statin use is associated with higher Calcium Density but is not associated with differences in other CAC quantification methods in patients with suspected CAD.