Calcium Scoring Assessed by 64 Multislice Coronary Angiography (MSCT) and its Relation with Presence and Extent of CAD
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Calcium Scoring Assessed by 64 Multislice Coronary Angiography (MSCT) and its Relation with Presence and Extent of CAD, GHADA SOLTAN, EHAB ABD EL FATAH, FATMA ABOUL-ENEIN, ASHRAF REDA and HEND EL DEEP
Abstract
Background: MSCT angiography has been reported to demonstrate a very high negative predictive value (more than 95%), indicating that it can be used as a reliable technique for excluding patients suspected of CAD, thereby reducing the need for invasive coronary angiography. Coronary calcium scoring (CS) using MSCT has been validated as a useful imaging tool for risk stratification and reclassification of the risk of CAD.
Aim of the Study: To assess the accuracy of CS in the detection and extent of CAD.
Methodology: 100 consecutive patients complaint of chest pain without history of myocardial infarction referred to the multislice CT coronary angiography center (ICC imaging center in Alexandria, from June 2009 to December 2009) All patients were subjected to full history taking, Through clinical examination, Laboratory investigation: Lipid profile, ECG, and MSCT & coronary artery calcium score (CS).
Results: Patients were divided into normal group (n=43), diseased group (n=57), which in turn was subdivided into two other groups: Obstructive n=43 and Non obstructive 14, Comparing normal and diseased groups there were Statistical significant differences regarding age (52.14±10.01 vs 56.46 ±9.61, p-value <0.05), presence of diabetes mellitus (23.3% vs 77.2%, p-value <0.01); frequency of metabolic syndrome (20.9% vs 45.6%, p-value <0.05), greater waist to hip ratio (0.88±0.04 vs 0.85±0.07, p-value <0.05) and Ca scoring (00.00±00.00 vs 159.65±226.88, p-value <0.01).
Comparing non obstructive and obstructive groups there, were highly statistical significant difference regarding Ca scoring (37.64±62.84 vs 199.37±246.65, p-value <0.01), the extent of CAD (No. of lesions) (1.50±0.76 vs 37.64±62.84, p-value <0.01) and Ca scoring in diabetic patients (27.44± 33.7 vs 241.88±254.98, p-value <0.01), subcutaneous fat (34.31±10.05 vs 27.99±9.86, value <0.05), and Ca scoring in hypertensive patients (42.89±78.27 vs 205.91±245.5) n=14.
Conclusion:
•The extent of CAD (No. of lesions) is directly related to the amount of the calcium score i.e increased Ca score is asso-ciated with increased number of the coronary lesions.
•Ca score is a good sensitive, good specific, and accurate test for detection of obstructive CAD (p-value <0.01).
•MSCT is a reliable technique for excluding patients suspected of CAD, thereby reducing the need for invasive coronary angiography.