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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Coronary calcification in patients with marker-positive acute coronary syndrome

Thomas Voigtländer1, Stefan Möhlenkamp, Holger Eggebrecht

  • 1Cardioangiologic Center Bethanien (CCB), Frankfurt/M, Germany. t.voigtlaender@ccb.de

Acta Radiologica (Stockholm, Sweden : 1987)
|September 21, 2010
PubMed

Insights

Coronary artery calcium (CAC) in the culprit lesion of acute coronary syndrome patients showed a trend toward higher amounts but was not statistically significant compared to remote segments. This finding impacts unstable coronary artery disease characterization.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • The diagnostic value of coronary artery calcium (CAC) scoring for unstable coronary artery disease (CAD) is debated.
  • Assessing CAC may help characterize acute coronary syndromes (ACS).

Purpose of the Study:

  • To compare CAC in culprit lesion segments versus remote segments in patients with marker-positive ACS.
  • Evaluate the role of CAC in identifying the site of acute plaque events.

Main Methods:

  • Thirty-two patients with marker-positive ACS underwent electron-beam computed tomography (EBCT) and coronary angiography.
  • Coronary anatomy was analyzed using the American Heart Association (AHA) segmental classification.
  • Intravascular ultrasound was used in select cases.

Main Results:

  • The mean CAC score in culprit segments (51±82) was not significantly different from remote segments (29±45) (P=0.14).
  • A trend for increased CAC in culprit lesion segments was observed but lacked statistical significance (P=0.4).
  • 81% of patients had higher CAC than expected for age and gender.

Conclusions:

  • CAC in culprit lesion segments of ACS patients shows a non-significant trend towards higher amounts.
  • CAC scoring may not reliably differentiate culprit from remote segments in ACS.
  • Further research is needed to clarify CAC's role in unstable CAD.
Abstract

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