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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary artery calcium progression after coronary artery bypass grafting surgery
Rami M Abazid1, Jonathan G Romsa2, Cigdem Akincioglu2
1London Health Sciences Centre, London, Ontario, Canada ramiabazid@yahoo.com.
Insights
Coronary artery calcium progression after coronary artery bypass grafting (CABG) surgery was analyzed. Diabetes mellitus was identified as the sole predictor of accelerated calcium progression post-CABG.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Imaging
Background:
- Accelerated atherosclerosis is a known complication following coronary artery bypass grafting (CABG).
- Quantifying coronary artery calcium (CCS) progression post-CABG is crucial for understanding long-term outcomes.
Purpose of the Study:
- To analyze the progression of coronary artery calcium (CCS) in patients after undergoing CABG surgery.
- To identify risk factors associated with accelerated CCS progression post-CABG.
Main Methods:
- Retrospective analysis of CCS Agatston score (AS), volume score (VS), and mass score (MS) in 39 patients before and after CABG.
- Evaluation of annualized CCS change and percent change in native and grafted coronary artery segments.
Main Results:
- No significant difference in annualized CCS percent change was observed between segments proximal to anastomosis and non-grafted coronary arteries.
- Multivariate regression analysis identified diabetes mellitus as the only significant predictor of >15% annualized CCS progression (HR, 8.12; p=0.04).
Conclusions:
- Coronary artery calcium does not exhibit accelerated progression immediately following CABG.
- Diabetes mellitus is the primary risk factor for significant CCS progression after CABG.
Objectives:
Accelerated atherosclerosis is a well-established phenomenon after coronary artery bypass grafting surgery (CABG). In this study, we analysed coronary artery calcium (CCS) progression after CABG.
Methods:
We retrospectively measured the CCS Agatston score (AS), volume score (VS) and mass score (MS) of 39 patients before and after CABG. The annualised CCS change and annualised CCS percent change of each coronary artery, coronary artery segments proximal and distal to anastomosis were analysed.
Results:
Mean age at the time of the surgery was 59.8±8.5 years. Follow-up period between the first and second CT scans was 6.7±2.8 (range, 1.1-12.8) years. Annualised CCS percent change (AS, VS and MS) of the coronary segments proximal-to-anastomosis did not differ from that of the non-grafted coronary arteries as follow: segments proximal-to-anastomosis: median (Q1-Q3) 12.8 (5.0-37.4), 13.7 (6.1-41.1) and 14.9 (5.4-53.7), left main coronary artery 12.6 (7.4-43.8), 22.0 (8.1-44.4) and 18.2 (7.3-57.4), non-grafted left circumflex artery: 13.5 (4.4-38.1), 10.5 (2.9-45.2) and 11.5 (7.1-47.9) and non-grafted right coronary artery: 31.4 (14.4-74.5), 25.2 (16.7-62.0) and 31.3 (23.8-85.6), respectively. Likewise, annualised percent change (AS, VS and MS) was similar between the native coronary arteries. Multivariate regression analysis showed that diabetes mellitus was the only predictor of annualised percent progression of the total CCS of >15% (HR, 8.12; 95% CI, 1.05 to 26.6; p=0.04).
Conclusion:
The CCS post-CABG did not follow an accelerated progression process. Among coronary artery disease risk factors, diabetes mellitus is the only predictor of annualised CCS percent progression of >15% post-CABG.
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