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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Aortic Arch Calcification, Plaque Morphology, and the Modified Glasgow Prognostic Score as Predictors of Major

Cagatay Bolgen1, Aziz Inan Celik2

  • 1Department of Interventional Radiology, Adana Medline Hospital, Turkey.

Angiology
|March 25, 2026
PubMed

Insights

Aortic arch calcification and morphology predict major adverse cardiovascular events (MACE). CTA assessment of aortic arch features improves cardiovascular risk stratification.

Area of Science:

  • Cardiovascular Imaging
  • Vascular Biology
  • Atherosclerosis Research

Background:

  • Aortic arch atherosclerosis signifies systemic vascular disease and impacts cardiovascular outcomes.
  • Systemic inflammation, indicated by the modified Glasgow Prognostic Score (mGPS), may affect plaque vulnerability.
  • Aortic arch calcification (AAC) and morphology (AAM) are key indicators of disease progression.

Purpose of the Study:

  • To investigate the relationship between AAC, AAM, and mGPS.
  • To evaluate the prognostic significance of AAC and AAM for major adverse cardiovascular events (MACE).
  • To determine if CTA-based aortic arch features can enhance cardiovascular risk stratification.

Main Methods:

  • Retrospective analysis of 516 patients who underwent computed tomography angiography (CTA).
  • Categorization of AAC (none, small, considerable) and AAM (none, smooth, ulcerated, protruding).
  • Kaplan-Meier survival analysis and multivariable Cox regression to identify MACE predictors.

Main Results:

  • Event-free survival declined with increasing AAC and AAM severity (log-rank P < .001).
  • Small and considerable AAC independently predicted MACE (P = .007 and P = .005).
  • Smooth, ulcerated, and protruding plaques significantly increased MACE risk (all P < .01). mGPS did not independently predict MACE.

Conclusions:

  • CTA-based assessment of AAC and AAM provides significant prognostic information for MACE.
  • Aortic arch features are valuable markers for long-term cardiovascular risk stratification.
  • mGPS, while correlated with plaque complexity, is not an independent predictor of MACE in this cohort.

Keywords:
aortic arch atherosclerosismajor adverse cardiovascular eventsmodified Glasgow Prognostic Scoreplaque morphology

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