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21-09-2023 | Computed Tomography | Cardiac

Different prognostic significance of coronary artery and aortic valve calcium in patients with chest pain

Authors: Marta Marcos-Mangas, Ana Revilla-Orodea, Teresa Sevilla, Esther González-Bartol, Israel Sánchez-Lite, Noelia Urueña-Martínez, Roman Arnold, Itziar Gómez, J. Alberto San Román

Published in: European Radiology | Issue 4/2024

Abstract

Objectives

Coronary artery calcification (CorCa) identifies high cardiovascular risk in the general population. In this setting, aortic valve calcification (AoCa) showed contradictory results. Our goal has been to assess the prognostic power of CorCa and AoCa in patients with chest pain who underwent an ECG-gated cardiac multidetector CT (cardiac-MDCT).

Methods

A total of 528 patients without previous known coronary artery disease, with chest pain who underwent a cardiac-MDCT multidetector, were retrospectively recruited. The primary endpoint included death, acute coronary syndrome, stroke, and heart failure.

Results

A total of 61 patients (11.6%) had an event during a mean follow-up of almost 6 years (5.95 ± 2.98). The most frequent event was acute coronary syndrome (6.4%). Total mortality was 4.5%. Patients with CorCa > 0 had more events than those without CorCa (17.3% versus 4.3%; p < 0.001). Likewise, when only patients without AoCa were considered (n = 118), clinical events were more frequent in those with CorCa (12.7% versus 3.6%; p = 0.004). After excluding patients with coronary artery disease, events were more frequent in those with CorCa (12.6% versus 4.3%; p = 0.004). The higher the Agatston score, the more frequent the events. Patients with AoCa > 0 had more events than those without (16.5% versus 7.3%; p < 0.001), but in patients without CorCa, no difference in events was seen (6.2% versus 3.6%; p = 0.471). A Cox regression analysis showed age, smoking, prior stroke, and CorCa but not AoCa to be independently related to events.

Conclusions

In summary, CorCa, but not AoCa, is related to cardiovascular events in patients with chest pain who undergo a cardiac-MDCT.

Clinical relevance statement

We show that coronary artery calcification, but not aortic valve calcification, detected in a coronary CT scan is tightly related to cardiovascular events. Although this is a message already shown by other groups in the general population, we do believe that this work is unique because it is restricted to patients with chest pain sent to coronary CT. In other words, our work deals with what we face in our routine everyday practice.

Key Points

• The presence and the amount of coronary artery calcification are associated with cardiovascular events in patients with chest pain.

• Aortic valve calcification is not associated with cardiovascular events in patients with chest pain.

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Title: Different prognostic significance of coronary artery and aortic valve calcium in patients with chest pain
Authors: Marta Marcos-Mangas
Ana Revilla-Orodea
Teresa Sevilla
Esther González-Bartol
Israel Sánchez-Lite
Noelia Urueña-Martínez
Roman Arnold
Itziar Gómez
J. Alberto San Román
Publication date: 21-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Arterial Diseases
Stroke
Acute Coronary Syndrome
Published in: European Radiology / Issue 4/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10229-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Different prognostic significance of coronary artery and aortic valve calcium in patients with chest pain

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance statement

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Clinical relevance statement

Key Points

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