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Updated: May 9, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Thoracic aortic calcification as a predictor of coronary artery disease: a systematic review and meta-analysis
Hussein Nafakhi1, Alaa Salah Jumaah2, Akeel Abed Yasseen2
1Department of Internal Medicine, Faculty of Medicine, University of Kufa, Kufa, Iraq.
Insights
Thoracic aortic calcification (TAC) is strongly linked to coronary artery disease (CAD) presence and severity. Calcification in the descending aorta and aortic root shows a greater association with CAD than other aortic segments.
Area of Science:
- Cardiology
- Vascular Biology
- Medical Imaging
Background:
- The association between thoracic aortic calcification (TAC) and coronary artery disease (CAD) is complex and debated.
- Conflicting evidence exists regarding the relationship between different segments of the thoracic aorta and CAD progression and outcomes.
Purpose of the Study:
- To investigate the correlation between thoracic aortic calcification (TAC) and the presence and severity of coronary artery disease (CAD).
- To clarify the relationship between specific segments of the thoracic aorta and CAD.
Main Methods:
- A systematic review and meta-analysis of studies published between January 1990 and September 2024.
- Included studies indexed in PubMed, Scopus, or EMBASE, examining the link between TAC and CAD.
- Utilized a random-effects model to calculate pooled odds ratios and confidence intervals for TAC association with CAD presence and severity.
Main Results:
- Included 17 studies with 8,187 participants; 2,775 had CAD.
- TAC was significantly associated with the presence of CAD (OR, 3.874; 95% CI, 2.789 to 5.381).
- TAC showed a stronger association with severe CAD (OR, 8.005; 95% CI, 2.611 to 24.542).
- Calcification in the descending aorta (53.4%) and aortic root (51%) had the strongest association with CAD.
Conclusions:
- Thoracic aortic calcification (TAC) is significantly associated with both the presence and severity of coronary artery disease (CAD).
- Calcification in the descending aorta and aortic root is more strongly linked to CAD compared to the aortic arch or ascending aorta.
Background:
The relationship between coronary atherosclerosis (progression, outcome) and calcification in the thoracic aorta (TAC), particularly across its various segments, is complex and often shows conflicting associations in the literature. To address this debated and complex relationship, we aimed to evaluate how TAC and its segments correlate with the presence and severity of coronary artery disease (CAD).
Methods:
We reviewed all articles published between January 1990 and September 2024 that examined the link between TAC and CAD and were indexed in PubMed, Scopus, or EMBASE. Using a random-effects model, we calculated pooled proportions, odds ratios, and corresponding 95% confidence intervals (CIs) to evaluate the association between TAC and CAD, with consideration of severity.
Results:
The study included 17 studies with 8,187 participants, 2,775 of whom had CAD (1,059 with severe CAD), and 5,412 of whom did not. The pooled odds ratio of TAC in patients with CAD compared to that in those without was 3.874 (95% CI, 2.789 to 5.381). For severe CAD versus mild CAD, the odds ratio was 8.005 (95% CI, 2.611 to 24.542). Calcification of the aortic root (pooled proportion, 51%; 95% CI, 0.282 to 0.733) or descending aorta (pooled proportion, 53.4%; 95% CI, 0.341 to 0.718) had the strongest association with CAD compared to calcification of the arch or ascending aorta.
Conclusions:
TAC is significantly associated with both the presence and severity of CAD. Calcification in the descending aorta and aortic root is more strongly linked to CAD than calcification in the arch or ascending aorta.
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