The significance of coronary artery calcium score as a predictor of coronary artery stenosis in individuals referred for CT angiography.

Reza Kiani,Mohammad Javad Alemzadeh-Ansari,Bahram Mohebbi,Hamidreza Pouraliakbar,Ata Firouzi,Ali Khademi,Zahra Hosseini,Farshad Shakerian,Mohamad Mehdi Peighambari,Ali Zahedmehr,Alireza Rashidinejad

doi:10.34172/jcvtr.2020.34

Abstract

Introduction: Cardiovascular diseases, including coronary artery disease (CAD), are among the most common causes of death in the elderly population. Recent studies have found that coronary artery calcium score (CACS) is a strong independent predictor of CAD. Here we aimed to investigate the association between CACS and demographic, clinical, laboratory, and CT angiographic findings inpatients with suspected CAD. Methods: From June 2008 to August 2018, we retrospectively reviewed 219 consecutive patients suspected with CAD who were referred for CT angiography in Rajaie Cardiovascular, Medical, and Research Center. Medical records were reviewed, and relevant demographic, clinical, laboratory and imaging were collected. Results: A total of 219 patients with an average age of 62.64±12.39 were included. Twelve patients(5.5%) had normal coronary angiography, and 50.2% had mild CAD. An obstructive CAD was found in97 patients (44.3%). The median CACS was 76.4 (IQR, 13.0-289.1). The frequency of obstructive CAD was 28.1% in the CACS <100 group, and 67.0% in CACS >100 group (P < 0.001). On multiple logistic regression analysis, age (OR=1.04 [1.01-1.07], P = 0.006), CACS (OR= 4.31 [2.33-7.98], P < 0.001), and neutrophil to lymphocyte ratio (NLR) (OR = 0.82 [0.68-0.98], P = 0.027) were independent predictors of obstructive CAD. Conclusion: We found a direct association between higher CACS and obstructive patterns in coronary CT angiography. Our findings indicate that the possibility of the presence of obstructive CAD was higher among symptomatic patients with older age, lower NLR, and CACS >100.

Highlights

Cardiovascular diseases, including coronary artery disease (CAD), are among the most common causes of death in the elderly population
Materials and Methods From June 2008 to August 2018, we retrospectively reviewed 219 consecutive patients suspected with CAD who were referred for computed tomography (CT) angiography in Rajaie Cardiovascular, Medical, and Research Center, affiliated to Iran University of Medical Sciences
In the present study, we evaluated the association between calcium score (CACS) and demographic, clinical, laboratory, and CT angiographic findings of patients suspected with CAD

Summary

Introduction

Cardiovascular diseases, including coronary artery disease (CAD), are among the most common causes of death in the elderly population. Recent studies have found that coronary artery calcium score (CACS) is a strong independent predictor of CAD. Our findings indicate that the possibility of the presence of obstructive CAD was higher among symptomatic patients with older age, lower NLR, and CACS >100. Male gender, hypertension, diabetes, dyslipidemia, obesity, smoking, and low physical activity are among the most established risk factors for cardiovascular diseases.[3,4] Recent studies have found that coronary artery calcium (CAC) is a strong independent predictor of CAD.[5,6,7,8] Calcification of the coronary arteries has an important role in the pathophysiology of atherosclerosis. Growing evidence suggests that CACS is a useful test for risk stratification of both symptomatic and asymptomatic individuals.[11,12,13] Higher CACSs has been shown to be associated with a higher risk of major cardiovascular events and all-cause mortality.[5,14,15]

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Methods

Conclusion