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Semi-Automatic Graphical Tool for Measuring Coronary Artery Spatially Weighted Calcium Score from Gated Cardiac Computed Tomography Images
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Semi-Automatic Graphical Tool for Measuring Coronary Artery Spatially Weighted Calcium Score from Gated Cardiac Computed Tomography Images

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Coronary artery calcification measured with electron-beam computerized tomography correlates poorly with coronary

Edward J Sharples1, Divaka Pereira, Shaun Summers

  • 1Department of Renal Medicine and Transplantation, Royal London and St Bartholomew's Hospital, London, UK. edsharps@doctors.org.uk

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|January 30, 2004
PubMed

Insights

Coronary artery calcification measured by electron-beam computerized tomography (EBCT) is not a reliable indicator of coronary artery stenosis in dialysis patients. A low calcification score may suggest the absence of significant narrowing.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Radiology

Background:

  • Coronary artery calcification (CAC) via electron-beam computerized tomography (EBCT) predicts cardiac events in the general population.
  • Uremic vascular calcification is prevalent in end-stage renal disease (ESRD) patients, differing in pattern from atherosclerosis.
  • It is often assumed CAC in ESRD patients reflects occlusive atherosclerotic disease.

Purpose of the Study:

  • To compare the predictive value of EBCT-assessed CAC with coronary angiography in ESRD patients.
  • To determine if CAC accurately reflects coronary artery stenosis in this population.

Main Methods:

  • Evaluated 18 ESRD patients undergoing maintenance dialysis.
  • Assessed 72 coronary vessels for angiographic stenosis and correlated with individual vessel calcification scores from EBCT.

Main Results:

  • No significant correlation found between individual vessel stenosis and CAC score in patients with positive calcium scans.
  • Specificity was 48%, and positive predictive value was 53%.
  • A CAC score <20 strongly correlated with absence of significant stenosis; a score of 0 had 87.5% negative predictive value.

Conclusions:

  • EBCT-measured CAC is not an accurate marker for coronary artery stenosis degree in uremic patients.
  • CAC should not be used as a sole screening tool for atherosclerotic coronary disease in ESRD.
  • Low CAC scores may be useful in ruling out significant stenosis.
Abstract

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