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Clinical significance of coronary artery calcification
Insights
Coronary artery calcification (CAC) is common in ischemic heart disease and linked to systemic arteriosclerosis. However, CAC is less frequent in vasospastic angina, suggesting different underlying mechanisms.
Area of Science:
- Cardiovascular Imaging
- Atherosclerosis Research
Background:
- Coronary artery calcification (CAC) is a marker of atherosclerosis.
- Plain CT scans can easily detect CAC.
- The clinical significance of CAC in cardiovascular diseases requires further clarification.
Purpose of the Study:
- To clarify the clinical significance of coronary artery calcification (CAC).
- To investigate the relationship between CAC and various clinical features in patients with and without ischemic heart disease.
Main Methods:
- Evaluated CAC and thoracic aortic calcification using plain CT scans (1-second scan time, 5 mm slice).
- Studied the association between CAC and clinical factors including age, sex, hypertension, diabetes mellitus, hyperlipidemia, smoking, ECG findings, and aortic calcification.
Main Results:
- CAC was more frequent in patients with ischemic heart disease (63%), older age (67%), aortic calcification (70%), and positive exercise stress tests (64%).
- CAC was less common in variant angina (30%).
- In younger patients (<70), CAC was associated with diabetes; in older patients, it was associated with hyperlipidemia.
Conclusions:
- Coronary artery calcification is associated with systemic arteriosclerosis and ischemic heart disease, excluding vasospastic angina.
- The findings suggest distinct pathophysiological pathways for different forms of angina.
- Further studies are needed to determine the prognostic value of CAC.
Abstract:
Coronary artery calcification (CAC) was easily demonstrated by plain CT-scan. The aim of this study was to clarify the clinical significance of CAC in cardiovascular diseases. The subjects were 90 patients with ischemic heart disease (30 myocardial infarction, 50 exertional angina pectoris and 10 variant form of angina pectoris; 46 males and 44 females, 68 +/- 10 y/o) and 50 patients without ischemic heart diseases (30 hypertension, 10 arrhythmia, 3 valvular disease, 2 cardiomyopathy, 2 congenital heart disease and 3 others; 25 males and 25 females 65 +/- 9 y/o). CAC and calcification of thoracic aorta were evaluated by plain CT-scan (1 second scan time and 5 mm slice). The relationship between CAC and other clinical features (age, sex, hypertension, diabetes mellitus, hyperlipidemia, smoking, resting ECG, exercise stress ECG, aortic calcification and optic fundi) were studied. CAC were seen more frequently in patients with ischemic heart disease (63%), old age (67%), aortic calcification (70%) and positive exercise testing (64%). On the other hand, CAC were rare in variant angina (30%). In younger patients (under 70 y/o), CAC were seen more frequently in diabetic patients. But, in older patients, CAC were frequently in those with hyperlipidemia. These results suggested that CAC was associated with not only systemic arteriosclerosis, but also ischemic heart disease, except vasospastic angina. The prognostic value of CAC would be studied later.