Original article Use of coronary calcium score in the assessment of atherosclerotic lesions in coronary arteries

Abstract

Introduction: Increased cardiovascular morbidity leads to search for new, non-invasive diagnostic methods for early detection of atherosclerosis. Among others computed tomography has become a matter of interest. The usefulness of quantitative analysis of calcification using multislice spiral computed tomography (MSCT) in cardiology has been studied recently. Aim: To evaluate the usefulness of calcium score (CS), estimated with MSCT, in identifying the risk of coronary artery stenosis. Methods: The analysis involved 340 consecutive patients, 222 men and 118 women, mean age 59.7±9.38 years. All patients were admitted to hospital with symptoms of coronary artery disease for coronary angiography. In all subjects risk factor assessment and CS estimation using MSCT were performed. Results: Mean CS was 271.1±605.9 and it increased with the progression of coronary artery disease. The differences between mean CS values in patients without coronary stenosis and patients with 1-, 2- or 3-vessel disease varied significantly (p <0.001). The cut-off point for total CS for the presence of coronary artery stenosis in the study group was set at ł56 (sensitivity 85.7% and specificity 85.3%). The likelihood of the absence of significant stenosis (negative predictive value) in the whole study group was 93.5% and in women reached 100%. Conclusions: Coronary calcium score is a valuable parameter in assessing the likelihood of presence of coronary stenosis. The absence of calcifications in coronary arteries (CS=0) excludes significant coronary stenosis with a high probability.