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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Correlation analysis of coronary artery tortuosity and calcification score
Min Li1, Zhen-Wei Wang1, Li-Juan Fang1
1Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, People's Republic of China.
Insights
Coronary artery tortuosity (CAT) is more common in females and linked to hypertension and age. While no overall link to calcium score was found, moderate coronary artery calcification (CAC) scores were associated with CAT in women.
Area of Science:
- Cardiovascular anatomy and pathology
- Medical imaging and diagnostics
Background:
- Coronary artery tortuosity (CAT) is a vascular anatomical variation.
- The relationship between CAT and coronary artery calcification (CAC) score requires further clarification.
- Identifying correlations can help define specific patient populations for prevention and intervention.
Purpose of the Study:
- To investigate the correlation between coronary artery tortuosity (CAT) and coronary artery calcification (CAC) score.
- To identify clinical factors associated with CAT.
Main Methods:
- A cross-sectional retrospective study of 1280 patients.
- CAT defined as ≥3 consecutive curvatures >45° in major epicardial coronary arteries.
- Multivariable regression analysis adjusted for clinical parameters affecting CAT.
Main Results:
- CAT was present in 35% of patients, more prevalent in females.
- Multivariable analysis showed CAT positively correlated with female sex, hypertension, and age.
- CAT was negatively associated with higher Body Mass Index (BMI).
- In female patients, CAT was significantly linked with moderate CAC score, hypertension, and high-density lipoprotein (HDL), and negatively with higher BMI.
Conclusions:
- CAT is more prevalent in females and associated with hypertension, age, and BMI.
- No significant multivariable correlation was found between CAT and overall CAC score or diameter stenosis.
- A correlation between CAT and moderate CAC score was observed in female patients.
Background:
Coronary artery tortuosity (CAT) is regarded as a variation of vascular anatomy, and its relationship with coronary artery calcification (CAC) score is still not well clarified. Studying the correlation between coronary artery calcification scores and CAT to determine specific prevention and intervention populations seems to have more meaningful.
Methods:
The study is a cross-sectional retrospective study, including 1280 patients. CAT is defined as the presence of at least three consecutive curvatures of more than 45°measured during systole or diastole of a major epicardial coronary artery. Multivariable regression analysis was used to adjust the clinical parameters directly affecting CAT.
Results:
Of these individuals, 445 (35%) were evaluated having CAT, of which females are higher than males (59.1% vs. 40.9%). Moderate CAC score (101-400) (odds ratio (OR) 1.49, 95% confidence interval [95%CI] 1.05-2.10, P = 0.025) revealed significantly associated with CAT on univariable analysis. However, multivariable analysis after adjusting for confounding factors only indicated that CAT was positively correlated with female (OR 1.68, 95%CI 1.30-2.17, P < 0.001), hypertension (OR 1.35, 95% CI 1.04-1.75, P = 0.024), and age (OR 1.02, 95% CI 1.01-1.03, P = 0.001), while was negatively associated with body mass index (BMI) 24-27.9(OR 0.76, 95% CI 0.58-1.00, P = 0.044), and BMI > 28 (OR 0.46, 95% CI 0.31-0.68, P < 0.001). Further analysis stratified by gender showed that compared with non-CAT, CAT was significantly linked with moderate CAC score (OR 1.79, 95% CI 1.00-3.20, P = 0.048), hypertension (OR 1.54, 95% CI 1.07-2.22, P = 0.021), and high-density lipoprotein (HDL) (OR 1.86, 95% CI 1.07-3.24, P = 0.028), while was negatively related to BMI > 28 (OR 0.51, 95% CI 0.31-0.84, P = 0.008) in female patients.
Conclusions:
CAT is more likely to be found in females, connected with hypertension, age, and BMI. No significant correlation is found between the presence of tortuosity and calcium score or diameter stenosis on multivariable analysis. Whereas the CAT is associated with moderate CAC score in correlation analysis when women are selected as the main group.
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