Use of coronary calcium score in the assessment of atherosclerotic lesions in coronary arteries.

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 > or =56 (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.