Is the coronary artery calcium score the first-line tool for investigating patients with severe hypercholesterolemia?

Abstract

Background 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. We therefore aimed to evaluate whether CAC scoring can be applied in the algorithm for clinical examination of patients with severe hypercholesterolemia (SH). Methods During 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. Results In 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). Conclusions CAC 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.

Subclinical cardiovascular disease and utility of coronary artery calcium score

“…A cross-sectional study by Kutkiene et al [157] included 213 participants aged 18–60 years of whom are 110 patients with severe hypercholesterolemia vs 103 patients with normal lipid profile in control group discerned no significant difference between severe hypercholesterolemia vs control groups on CACs percentiles (25th, 50th, 75th and 90th percentiles) among neither males (p = 0.706) and females (p = 0.272), moreover, ultrasonographical detected Achilles tendon xanthomas had no significant association with CACs percentiles.…”

Coronary Artery Calcium Score: Assessment of SYNTAX Score and Prediction of Coronary Artery Disease

“…Calcium score is strongly associated with coronary artery calcification and luminal stenosis [ 15 ]. It is a reliable tool for calculating the risk of myocardial infarction, coronary death, and all-cause mortality, and is also used to assess asymptomatic patients [ 16 ].…”

“…Using a registry of 25,753 asymptomatic patients who had CAC scans done were followed for long-term mortality, a study demonstrated that the number of coronaries with CAC score of >100, location of CAC, and several calcific lesions indicated coronary events [ 16 ]. According to a study conducted by Berman et al, the CAC score of zero indicates a low risk of cardiovascular disease at 15 years and generally favors a more conservative approach for management.…”

The evaluation of the coronary arteries calcification degree by the method of cardiovascular MSCT in patients with vitamin D and homocysteine metabolism disturbance

“…The density factor is calculated by the peak density of the calcification zone, which is expressed in Hounsfield units (HU). The coronary artery calcinosis (CAC) is defined as an area with a density greater than 130 HU [7][8][9][10].…”