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

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.

Relationship between Coronary Artery Calcium Score and Coronary Stenosis

“…Besides, CACS ≥1300 yielded good specifcity and a positive predictive value of 100% for diagnosing coronary Such patients can make an informed decision about foregoing CCTA and instead choose early percutaneous coronary revascularization based on their preferences regarding invasive procedures. Kiani et al showed that age exerts an impact on the optimal cutof value [10,11]. Durhan et al conducted a ROC curve analysis to assess the predictive ability of CACS for coronary artery stenosis across diferent age groups, revealing that patients aged 50-59 exhibited a signifcantly higher AUC than other age groups [12].…”

Image Characteristics of Virtual Non-Contrast Series Derived from Photon-Counting Detector Coronary CT Angiography—Prerequisites for and Feasibility of Calcium Quantification

“…Electrocardiogram-synchronized, non-enhanced computed tomography (NECT) scans of the heart are the primary non-invasive imaging modality for assessing the presence and extent of coronary artery calcification [1], a direct measure of an individual's burden of coronary atherosclerosis [2]. The coronary artery calcium score (CACS) has substantial prognostic value for predicting major adverse cardiovascular events and even long-term mortality in both asymptomatic [3][4][5][6] and symptomatic individuals [7,8], and it enhances cardiovascular risk stratification beyond traditional risk factor models [9][10][11]. NECT for Diagnostics 2023, 13, 3402 2 of 13 calcium scoring may be performed as a stand-alone examination in asymptomatic individuals [12].…”