Segmental thoracic aorta calcification in diabetic patients: Relationship with coronary atherosclerosis burden

Thoracic aortic calcification (TAC) reflects systemic atherosclerosis. The specific relationship between DM and the extent and distribution of calcification within the thoracic aorta and its segments has not been fully elucidated in the literature. We aimed to assess the association of calcification of aorta segments, including root, ascending, arch, and descending parts, with coronary atherosclerotic burden, including CAC, stenosis severity, and non-calcified plaque in patients with DM.

This retrospective study included symptomatic patients with suspected coronary artery disease who underwent a 256-slice multi-detector computed tomography angiography examination between May and December 2024.

A total of 138 symptomatic patients were enrolled in this study. The enrolled patients were categorized into two groups: DM group (n = 60, with a mean age 58 ± 12 years and 42% males) and non-DM group (n = 78, with a mean age 54 ± 11 years and 53% males). Calcification of the descending aorta was significantly associated with the presence of significant coronary stenosis (≥ 50%), and this association remained statistically significant after adjustment for conventional coronary risk factors (P = 0.020). Calcification in the aortic root (r = 0.2, P = 0.016), ascending aorta (r = 0.3, P = 0.004), and descending aorta (r = 0.3, P = 0.002) was significantly correlated with CAC. However, these associations did not remain significant in regression analysis after adjusting for coronary risk factors. Calcification at different thoracic aorta segments showed no significant association with the presence of non-calcified coronary plaque.

Calcification of the descending aorta was independently associated with significant coronary stenosis in patients with DM.