Association between aortic calcification and stable obstructive coronary artery disease
ABSTRACT Coronary artery calcification (CAC) is correlated with aortic calcification (AC) and predicts coronary atherosclerosis as well as obstructive coronary artery disease (OCAD). This study aims to investigate whether AC predicts OCAD independent of CAC and its incremental value in predicting OCAD with CAC.
Among the consecutive patients who underwent 64-slice multidetector CT (MDCT), we enrolled 120 stable OCAD (luminal narrowing ≥ 50%) patients and 120 controls without OCAD, matched for cardiovascular risk factors. CAC, thoracic AC, and OCAD were determined by MDCT.
The prevalence of AC and CAC were significantly higher in OCAD patients than in controls (64% vs. 48%, p = 0.019; 57% vs. 32%, p < 0.001, respectively). There is a significant correlation between AC and CAC scores in the overall study population (r = 0.528, p < 0.001). In univariate analysis, the odds ratios (ORs) of AC and CAC in predicting OCAD were 1.91 (95% CI, 1.14-3.21) and 2.82 (95% CI, 1.67-4.78), respectively. When an adjustment was made for each other, AC did not maintain a significant association with OCAD, whereas CAC persisted the association (OR, 2.52; 95% CI, 1.42-4.47). Both AC and CAC present as compared to both absent was found to be a more potent predictor for OCAD (OR, 3.37; 95% CI 1.78-6.36, p < 0.001) than CAC alone.
The presence of AC was associated with stable OCAD independently from cardiovascular risk factors, but the association seemed to be based on the close correlation between AC and CAC. However, AC might have an incremental value with CAC for predicting OCAD.
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ABSTRACT: Thoracic aortic calcium deposits are frequently detected on tomography of the chest, and in other imaging modalities. Numerous studies indicated the correlation of hemodynamic parameters such as wall shear stress in relation to distribution aortic calcifications. This publication discusses similarities and differences of two distinct pathomechanisms of arterial calcifications: intimal associated with atherosclerosis and medial knows as Mönckeberg's arteriosclerosis. This review also analyzes the frequent coexistence of aortic calcification and coronary artery disease in terms of risk of cardiovascular events.Polish Journal of Radiology 02/2013; 78(2):38-42. DOI:10.12659/PJR.883944
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ABSTRACT: Aortic knob calcification (AC) is associated with increased risks of cardiovascular and cerebrovascular events. We evaluated the clinical importance of AC in ischemic stroke patients with intracranial (IC) stenosis using simple, non-invasive and routine chest radiography. The presence of AC was assessed in a chest posteroanterior view in 307 acute ischemic stroke patients admitted from May 2009 to April 2010, and who underwent magnetic resonance angiography or distal subtraction angiography. The association of AC with IC stenosis was analyzed. Patient age (68.3±8.7 vs. 65.9±8.27 years, P=0.04), and the prevalence of IC stenosis (70.7 vs. 41.3%, P<0.01) were higher in patients with AC than in patients without calcification. After adjusting for age, gender and vascular risk factors, logistic regression analysis showed that AC (Odds ratio, 3.54; 95% confidence interval, 1.90 to 6.61, P<0.01) and age (Odds ratio, 1.79; 95% confidence interval, 1.01 to 3.19; P=0.04) were independent factors affecting IC stenosis. AC appears to be a reliable predictor for IC stenosis, an important mechanism of ischemic stroke.05/2013; 15(2):122-125. DOI:10.5853/jos.2013.15.2.122
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ABSTRACT: The association between atherosclerosis in the descending thoracic aorta (DTA) visualized on computed tomography coronary angiography (CTA) and coronary artery disease (CAD) has not been extensively explored. Therefore, a comprehensive analysis of DTA atherosclerosis on CTA was performed and the association of DTA atherosclerosis with CAD was evaluated in patients with suspected CAD. A total of 344 patients (54 ± 12 years, 54 % men) with suspected CAD underwent CTA. CTA were classified based on CAD severity in no signs of atherosclerosis or minor wall-irregularities <30 %, non-significant CAD 30-50 %, or significant CAD ≥50 % stenosis. The DTA was divided in segments according the posterior intercostal arteries. Per segment the presence of atherosclerotic plaque (defined as ≥2 mm wall thickness) was determined and maximal wall thickness was measured. Plaque composition was scored as non-calcified or mixed and the percentage of DTA segments with atherosclerosis was calculated. Significant CAD was present in 152 (44 %) patients and 278 (81 %) had DTA atherosclerotic plaque. DTA maximal wall thickness and percentage of DTA segments with atherosclerosis were 2.7 ± 1 mm and 49 ± 36 %. The presence, severity and extent of DTA atherosclerosis significantly increased with increasing CAD severity. Multivariate logistic regression analysis corrected for age and other risk factors demonstrated independent associations of DTA plaque (OR 6.56, 95 % CI 1.78-24.19, p = 0.005) and maximal DTA wall thickness (OR 2.00, 95 % CI 1.28-3.12, p = 0.002) with significant CAD. The presence and severity of DTA atherosclerosis were independently related with significant CAD on CTA in patients with suspected CAD.The international journal of cardiovascular imaging 07/2013; 29(8). DOI:10.1007/s10554-013-0266-y · 2.32 Impact Factor