A Pilot Study on the Association between Cardiovascular Risk Factors and Coronary Artery Calcification in a Group of Patients Investigated via Cardiac Computed Tomography in a European Country with High Cardiovascular Risk

Abstract

(1) Background: Cardiovascular disease is the leading cause of mortality worldwide; the prevention and early detection of coronary artery disease are of critical importance; and the coronary artery calcium score is a powerful method in the assessment of coronary artery disease. Among European countries, Romania ranks as a country with a very high risk of cardiovascular diseases, but the data are limited in regard to the prevalence of the calcium score. (2) Methods: A retrospective study was conducted to establish the coronary calcium score in a group of patients investigated via cardiac CT and to determine the correlation with the presence of cardiovascular risk factors. (3) Results: According to the Agatston calcium score, 50% of the patients had a positive calcium score. High calcium scores above 400 UA were present in 12.6% of patients. Regarding the association between the presence of cardiovascular risk factors and the levels of coronary artery calcification, a mild level of calcification was associated with age over 50 years (X2 = 3.88, p = 0.04, OR = 3.25; 95% CI 0.94–11.14); a moderate level of calcification with the age of patients over 50 years (X2 = 6.54, p = 0.01, OR = 5.58; 95% CI 1.29–24.16), dyslipidemia (X2 = 7.28, p = 0.007, OR = 3.37; 95% CI 1.34–8.51), and arterial hypertension (X2 = 5.37, p = 0.02, OR = 2.88; 95% CI 1.14–7.27); a severe level of calcification with hypertension (X2 = 4.61, p = 0.03, OR = 7.03; 95% CI 0.90–54.81); and a very severe level of calcification with hypertension (X2 = 4.61, p = 0.03, OR = 7.03; 95% CI 0.90–54.81), smoking (X2 = 8.07, p = 0.004, OR = 4.44; 95% CI 1.47–13.44), and diabetes (X2 = 13.65, p = 0.001, OR = 6.59; 95% CI 2.5–20.18). (4) Conclusion: Half of the patients investigated by using cardiac CT had a calcium score of zero. Predictors for coronary calcium scores in relation to risk factors varied. For the very severe coronary calcification level, the strongest predictor was the presence of smoking and diabetes, which increased the odds for very severe calcification by 13.46 times. Patients who had multiple cardiovascular risk factors, hypertension, diabetes, and smoking were 9.18 times more likely to have very severe calcification.