Value of Coronary Artery Calcium Score to Predict Severity or Complexity of Coronary Artery Disease

Abstract

Background Prediction of severity or complexity of coronary artery disease (CAD) is valuable owing to increased risk for cardiovascular events. Although the association between total coronary artery calcium (CAC) score and severity of CAD, Gensini score was not used, it has been previously demonstrated. There is no information about the association between total CAC score and complexity of CAD. ObjectivesTo investigate the association between severity or complexity of coronary artery disease (CAD) assessed by Gensini score and SYNTAX score (SS), respectively, and coronary artery calcium (CAC) score, which is a noninvasive method for CAD evaluation in symptomatic patients with accompanying significant CAD. MethodsTwo-hundred-fourteen patients were enrolled. Total CAC score was obtained before angiography. Severity and complexity of CAD was assessed by Gensini score and SS, respectively. Associations between clinical and angiographic parameters and total CAC score were analyzed. ResultsMedian total CAC score was 192 (23.0-729.8), and this was positively correlated with both Gensini score (r: 0.299, p<0.001) and SS (r: 0.577, p<0.001). At multivariate analysis, it was independently associated with age (ß: 0.154, p: 0.027), male gender (ß: 0.126, p: 0.035) and SS (ß: 0.481, p< 0.001). Receiver-operating characteristic (ROC) curve analysis revealed a cut-off value > 809 for SS >32 (high SS tertile). ConclusionIn symptomatic patients with accompanying significant CAD, total CAC score was independently associated with SS and patients with SS >32 may be detected through high Agatston score.

Angiographic coronary artery disease and high-sensitivity troponin-T in a native Pakistani cohort presenting with chronic chest pain

“…Data from migrant Indian Asian populations show little difference in coronary calcium scores in men between Asians and Caucasians in the USA . This study was conducted before coronary artery calcium score measurement became routine and used a semi‐quantitative measure of CAD atheroma burden (Gensini score) that shows a weak correlation ( r = 0.30) with coronary calcium scores . However, in general calcium scores correlate with severity of atheromatous disease measured on CT coronary angiography in Pakistani populations suggesting that this relationship is still relevant to modern practice.…”

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

“…A study done by Gökdeniz et al indicated that cut-off value of CAC greater than 809 with sensitivity of 67.6% and specificity of 87.6% could be used to predict high SYNTAX score in patients [ 13 ]. However, in our study, the cut-off of the total CAC score in predicting patients with SYNTAX score of >27 was 212 (AUC = 0.743, 95% CI = 0.589-0.896, p = 0.007).…”

“…The relationship between CAC score and its quantification of future cardiac events has been demonstrated. Some studies have shown an association of CAC score with angiographically proven CAD [ 13 , 14 ].…”

The value of coronary artery calcium score assessed by dual-source computed tomography coronary angiography for predicting presence and severity of coronary artery disease

“…Calcium score based on the Agatston method was defined as the presence of a lesion with an area greater than 1 mm 2 , and peak intensity greater than 130 Hounsfield Units, which was automatically identified and marked with color by the software. All lesions were added to calculate the total calcium score with the Agatston method [ 22 ].…”