Abstract
BackgroundCoronary artery calcium (CAC) is known as a reliable tool for estimating risk of myocardial infarction, coronary death, all-cause mortality and is even used to evaluate suitable asymptomatic patients. We therefore aimed to evaluate whether CAC scoring can be applied in the algorithm for clinical examination of patients with severe hypercholesterolemia (SH).MethodsDuring the period of 2016–2017 a total of 213 asymptomatic adults, underwent computed tomography angiography to evaluate their CAC scoring. The sample consisted of 110 patients with SH and 103 age and sex matched controls without dyslipidemia and established cardiovascular disease.ResultsIn total there were 79 (37.2%) subjects with elevated (≥25th) CAC percentiles. Out of them 47 (59.5%) had SH and 32 (40.5%) did not. CAC score did not differ between groups (SH (+) 140.30 ± 185.72 vs SH (−) 87.84 ± 140.65, p = 0.146), however there was a comparable difference in how the participants of these groups distributed among different percentile groups (p = 0.044). Gender, blood pressure, tabaco use, physical activity, family history of coronary artery disease and diabetes mellitus were not associated with CAC score (p > 0.05). There were no significant correlations between biochemical parameters and CAC percentiles except for increase in lipoprotein(a) (p = 0.038). Achilles tendon pathology, visceral obesity, body mass index and increased waist-hip ratio were not associated with CAC percentiles either (p > 0.05).ConclusionsCAC score is not associated with presence of SH. CAC score is not an appropriate diagnostic tool in the algorithm for clinical examination of patients with SH. Further larger studies are needed to support our findings.
Highlights
Coronary artery calcium (CAC) is known as a reliable tool for estimating risk of myocardial infarction, coronary death, all-cause mortality and is even used to evaluate suitable asymptomatic patients
There were no significant correlations between biochemical parameters and CAC percentiles except for lipoprotein(a)
Even though CAC score did not differ between groups (severe hypercholesterolemia (+) 140.30 ± 185.72 vs severe hypercholesterolemia (−) 87.84 ± 140.65, p = 0.146) (Table 3), there was a comparable difference in how the participants of these groups distributed among different percentile groups (p = 0.044) according to their age, gender, race/ethnicity (Fig. 2)
Summary
Coronary artery calcium (CAC) is known as a reliable tool for estimating risk of myocardial infarction, coronary death, all-cause mortality and is even used to evaluate suitable asymptomatic patients. In 2016 cardiovascular disease (CVD) remained a major cause of mortality in Lithuania (56.1%) with rates of deaths from coronary heart disease (CHD) being the highest in Europe [1, 2]. Dyslipidemia, hypertension and hyperphosphatemia (in patients with renal disease) all are major clinical risk factors for coronary artery. Coronary artery calcium (CAC) is established as a reliable tool for estimating risk of myocardial infarction, coronary death and all-cause mortality [13,14,15]. Guidelines around the world endorse the use of non-contrast cardiac computed tomography (CT) for assessing CAC score among suitable asymptomatic patients in pursue of better clinical risk evaluation [13]. The absence of calcium in the coronary arteries does not rule out atherosclerotic disease it is thought to indicate an excellent long-term prognosis [19, 20]
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