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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
The relationship between carotid and coronary calcification in patients with coronary artery disease
Rafik Shenouda1,2, Sergio Vancheri3, Emilio Maria Bassi3
1International Cardiac Centre - ICC, Alexandria, Egypt.
Insights
Coronary artery calcification is significantly higher than carotid artery calcification in patients with coronary artery disease. While hypertension relates to carotid calcification, diabetes and dyslipidemia correlate with coronary calcification.
Area of Science:
- Cardiovascular medicine
- Radiology
- Atherosclerosis research
Background:
- Atherosclerosis is a complex, multi-system disease affecting various arteries.
- Understanding the interplay between carotid and coronary calcification is crucial in patients with established coronary artery disease.
Purpose of the Study:
- To investigate the relationship between the presence and severity of carotid and coronary artery calcification.
- To analyze correlations between different arterial calcification sites and traditional atherosclerosis risk factors.
Main Methods:
- Sixty-three patients with coronary artery disease underwent CT scanning of carotid and coronary arteries.
- Agatston scoring system was used to quantify calcification in both vascular beds.
- Correlation analysis was performed between calcification scores and risk factors like hypertension, diabetes, and dyslipidemia.
Main Results:
- Coronary artery calcium scores were substantially higher than carotid artery calcium scores.
- Left and right carotid calcification showed strong correlation, unlike coronary calcification.
- Coronary calcification modestly correlated with carotid calcification, particularly the left side.
- Hypertension correlated with carotid calcification; diabetes and dyslipidemia correlated with coronary calcification.
Conclusions:
- Carotid calcification patterns are similar bilaterally, contrasting with coronary arteries in patients with coronary disease.
- A modest correlation exists between coronary and carotid calcification, with coronary scores being significantly higher.
- Specific risk factors differentially associate with carotid versus coronary calcification, highlighting distinct pathophysiological pathways.
Background:
Atherosclerosis is a multi-system pathology with heterogeneous involvement. We aimed to investigate the relationship between the presence and severity of carotid and coronary calcification in a group of patients with coronary artery disease.
Methods:
Sixty-three patients presenting with unstable angina or positive stress test for myocardial ischaemia were enrolled in this study. All patients underwent CT scanning of the carotid and coronary arteries using the conventional protocol and Agatston scoring system. Risk factors for atherosclerosis were also analyzed for correlation with the extent of arterial calcification.
Results:
Total coronary artery calcium score (CAC) was several times higher than total carotid calcium score (1274 (1018) vs 6 (124), p = 0·0001, respectively). The left carotid calcium score correlated strongly with the right carotid calcium score (rho = 0·69, p < 0·0001). The total CAC score correlated modestly with the total carotid calcium score (rho = 0·34, p = 0·007), in particular with left carotid score (rho = 0·38, p = 0·002), but not with the right carotid score. The left coronary calcium score correlated with the right coronary calcium score (rho = 0·35, p = 0·004), left carotid calcium score (rho = 0·33, p = 0·007) and left carotid calcium score at the bifurcation (rho = 0·34, p = 0·006). While hypertension correlated with carotid calcium score, diabetes and dyslipidaemia correlated with left CAC score.
Conclusion:
In patients with coronary disease, the carotid calcification pattern appeared to be similar between the right and left system in contrast to that of the coronary arteries. CAC correlated only modestly with the carotid score, despite being significantly higher. Hypertension was related to carotid calcium score while diabetes and dyslipidaemia correlated with coronary calcification.
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