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Updated: Jun 20, 2026

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Associations of segment-level coronary calcium scoring metrics with major and minor cardiovascular events

Sotirios Tsogias1, Bernhard Föllmer2, Kenrick Schulze1

  • 1Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charitéplatz 1, Berlin, 10117, Germany.

Journal of Cardiovascular Computed Tomography
|June 18, 2026
PubMed

Insights

Coronary artery calcium (CAC) diffusivity metrics predict major adverse cardiovascular events (MACE) better than traditional scoring. Segment-level CAC analysis offers valuable insights into cardiovascular risk beyond standard methods.

Area of Science:

  • Cardiology
  • Radiology
  • Preventive Medicine

Background:

  • Coronary artery calcium (CAC) scoring is established for assessing coronary artery calcification.
  • Limited evidence exists on segment-level CAC assessment for clinical risk prediction.

Purpose of the Study:

  • To assess the association of CAC diffusivity index and number of calcified segments with major adverse cardiovascular events (MACE) and minor adverse cardiovascular events (MICE).
  • To evaluate if segment-level CAC metrics provide additional risk prediction beyond traditional scoring methods.

Main Methods:

  • Prespecified analysis of the DISCHARGE Trial (NCT02400229) including 833 patients with coronary calcification.
  • Extracted CAC diffusivity index, risk groups, and number of calcified segments.
  • Assessed association with MACE and MICE using Kaplan-Meier analysis and Cox regression.

Main Results:

  • High CAC diffusivity was associated with a 4.5-fold increased risk of MACE.
  • A 3% increase in MACE risk per diffusivity index unit was observed.
  • CAC diffusivity metrics showed significant association with MACE beyond traditional scoring; association with MICE was weak.

Conclusions:

  • CAC diffusivity metrics offer significant prognostic value for MACE, independent of traditional CAC scoring.
  • Segment-level CAC analysis, particularly diffusivity, enhances cardiovascular risk assessment.
  • The number of calcified segments showed a significant association only with MICE.
Abstract

Keywords:
Cardiac imaging techniquesComputed tomography, X-RayCoronary artery calciumCoronary artery diseaseObserver variation

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