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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Aortic valve calcium on spiral computed tomography (dual slice mode) is associated with advanced coronary calcium in
Yehuda Adler1, Joseph Shemesh, Alexander Tenenbaum
1Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Tel-Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel. aldery@yahoo.com
Insights
Aortic valve calcium (AVC) is linked to advanced coronary calcium (CC) in hypertensive patients. This finding reinforces the association between AVC and increased cardiovascular mortality risk.
Area of Science:
- Cardiology
- Radiology
- Preventive Medicine
Background:
- Aortic valve calcium (AVC) is prevalent in the elderly, correlating with increased cardiovascular mortality and myocardial infarction risk.
- The study investigates the association between AVC and coronary calcium (CC) in high-risk hypertensive individuals.
Purpose of the Study:
- To determine if a correlation exists between aortic valve calcium (AVC) and coronary calcium (CC) in high-risk hypertensive patients.
- To assess the predictive value of AVC for advanced coronary calcification.
Main Methods:
- Dual-slice spiral computed tomography (DHCT) was used to assess AVC and coronary calcium (CC) in 376 hypertensive patients.
- Coronary calcium scoring was performed, defining advanced CC as a total score >300.
- Patients were categorized into groups with and without AVC, with the latter serving as controls.
Main Results:
- Aortic valve calcium (AVC) was identified in 70 patients, with significantly higher mean CC scores (388 vs. 147, P<0.001) compared to the non-AVC group.
- The presence of AVC was associated with advanced CC (27% vs. 15%, P=0.02) and multi-vessel calcification.
- Logistic regression identified age, gender, and AVC as independent predictors of advanced CC.
Conclusions:
- A significant association exists between aortic valve calcium (AVC) and advanced coronary calcium (CC) detected by spiral CT.
- These findings support the link between AVC and elevated cardiovascular mortality risk.
Background:
Aortic valve calcium (AVC) is common in the elderly and is associated with an increase risk of death from cardiovascular causes and of myocardial infarction. The goal of the present study was to determine whether an association exists between the presence of AVC and coronary calcium (CC) in high-risk hypertensive patients as detected by spiral computed tomography (dual slice mode) (DHCT).
Design And Methods:
Three hundred and seventy-six hypertensive patients participating in the International Nifedipine Gastrointestinal Therapeutic System (GITS) Study of Intervention as a Goal in Hypertension Treatment (INSIGHT) in our region were included (197 men and 179 women, age range 55-79 years). All underwent DHCT of the heart for CC scoring using previously published methods. A positive test for the presence of CC was defined as the presence of at least one lesion with an area of 0.5 mm and DHCT density above 90 Hounsfield units (total CC score >0). CC was considered advanced when total calcium score was >300. AVC was defined by DHCT as any detected calcified deposit in the region of the aortic valve. Patients without AVC served as the control group.
Results:
AVC was documented in 70 patients (36 men, 34 women; mean age 66 +/- 5 years, range 57-79 years). The age- and sex-matched non-AVC group (control group) included 306 patients (161 men, 145 women; mean age 67 +/- 5 years, range 55-75 years). There were no intergroup differences in risk factors for atherosclerosis. Significant differences were found between AVC and the control groups for mean CC score (388 +/- 754 compared with 147 +/- 307, P< 0.001) and between the presence of advanced CC and the control group (27 compared with 15%, P= 0.02). Significant differences were also found for the presence of three-vessel calcification (36 compared with 21%, P= 0.01) and the number of vessels involved (1.8 +/- 1.1 compared with 1.4 +/- 1.1, P= 0.01). Stepwise logistic regression found age [odds ratio (OR) 1.08, 95% confidence intervals (CI) 1.03-1.15), gender (OR 0.45, 95% CI 0.25-0.82) and AVC (OR 2.07, 95% CI 1.06-4.02)] to be the only variables that predict advanced CC.
Conclusions:
Our study demonstrated a significant association between the presence of AVC and advanced CC on spiral computed tomography. These results strengthen earlier findings of a high association between AVC and increased risk of death from cardiovascular causes.
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