Utility of Per Vessel Coronary Artery Calcium (CAC) Score in Symptomatic Patients Undergoing Coronary Computed Tomography in Predicting Major Adverse Cardiovascular Events: Single Center Experience and Literature Review.
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Date
2014-08-01
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Abstract
Background: Atherosclerotic vascular disease remains a significant etiology of morbidity
and mortality in the United States. Coronary artery calcium (CAC) is associated with
increased stroke incidence and coronary atherosclerotic burden. Uncertainty remains
regarding how best to interpret non-zero CAC scores, particularly in symptomatic
patients.
Methods: A review of the first 1122 patients who underwent coronary CT angiography (CCTA) with CAC scoring from January 2005 until July 2012 was performed. Patients
were dichotomized into 2 groups, zero CAC score and non-zero CAC score. Non-zero
CAC patients were further subdivided based on the specific coronary artery containing
calcium. Rates of major adverse cardiovascular events (MACE) defined as all-cause
mortality, non-fatal myocardial infarction (MI), ischemic stroke, and late revascularization
(>90 days following CCTA) were evaluated in each group.
Results: 505 patients (63% male, mean age 60 ± 11) with non-zero CAC scores were
analyzed over a six year period with resultant median follow up period of 22 months
(IQR25,75 13-34 months). Major adverse cardiovascular events were observed in 11
patients. Receiver-operator curve (ROC) analysis on each coronary segment showed
significance with the presence of left main (LM) CAC (AUC 0.752, p=0.004).
Conclusions: The presence of CAC at any value in the LM in this case series appears
to predispose patients to increased rates of MACE.
Description
Keywords
CAC, left main coronary, symptomatic, outcomes, CCTA
Citation
Prentice Ryan L, Barnwell Megan L, Thomas Dustin M, Ahmadian Homayoun R, Jones Ronald L, Lin Charles K, McDonough Ryan J, Rubal Bernard J, Slim Ahmad M. Utility of Per Vessel Coronary Artery Calcium (CAC) Score in Symptomatic Patients Undergoing Coronary Computed Tomography in Predicting Major Adverse Cardiovascular Events: Single Center Experience and Literature Review. British Journal of Medicine and Medical Research. 2014 Aug; 4(22): 3933-3940.