Study of coronary artery calcium by multi-slice spiral CT as a tool for high risk cardiovascular screening
DOI:
https://doi.org/10.18203/2320-6012.ijrms20173723Keywords:
CAC, Cardiovascular risk, ScreeningAbstract
Background: Strong relationship has been demonstrated between the presence of occlusive CAD and coronary artery calcification (CAC) detected at autopsy, fluoroscopy and computed tomography (CT scan). CT scan quantifies the relative burden of CAC deposits as a marker of atherosclerosis. We explored utility of multi-slice spiral CT scan for detection of CAC as a tool for screening in asymptomatic high-risk cases above 40 years of age.
Methods: Fifty-eight asymptomatic cardiovascular high-risk cases were included as per selection criteria. Detailed clinical history was recorded in every case regarding age, sex, history of risk factors for CAD like systemic hypertension, diabetes mellitus, smoking and family history of CAD. Every case was evaluated for fasting and postprandial blood sugar and fasting lipid profile. Body mass index (BMI) was calculated. An ECG was also recorded. Coronary artery calcium was estimated in each patient by multi -slice spiral CT scan. Fifty age and gender matched consenting participants were enrolled as controls and comparisons drawn.
Results: Out of 58 cases scanned, 41 had no detectable CAC by multi-slice CT scan whereas in 17 cases (29.2%), calcium was detected. Mean CAC score was observed to increase as number of risk factors increased.
Conclusions: Multi-slice CT scan is a useful tool for detection of coronary artery calcium (CAC) when utilised for high risk screening in older adults having one or more known cardiovascular risk factors.
References
Sethi KK. Ischemic Heart Disease, Siddaharth N. Shah (Edit.) in API Text Book of Medicine, 7th Edition; 2003;432-33.
Schmermund A, Mohlenkamp S, Erbel R. The latest on the calcium story. Am J cardiol. 2002;90:12.
Shrivastava S, Agrawal V, Kasliwal RR. Coronary calcium and coronary artery disease: an Indian perspective. Indian Heart J. 2003;55:344-8.
Kondos GT, Hoff JA, Sevrukov A. Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5,635 initially asymptomatic low to intermediate risk adults. Circ. 2003;107:2571-6.
O’ Malley PG, Taylor AJ, Jackson JL. Prognostic value of coronary electron beam computed tomography for coronary heart disease events in asymptomatic population. Am J cardiol. 2000;85:945-8.
Stanford W, Thompson BH. Imaging of coronary artery calcification. Radiol. 1999;37:257-72.
Chobanian AV, Bakris GL, Blank HR. The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. The JNC report. JAMA. 2003;289:2560-72.
Americal Diabetes Association. Clinical practice recommendations 2002. Diabetes Care. 2004;27:51.
Summary of III report of NCEP expert panel on detection evaluation and treatment of high blood cholesterol in adults (ATP III). JAMA. 2001;285(19):2486-97.
Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827-32.
Goel M, Wong ND, Eisenberg H. Risk factor correlates of coronary calcium as evaluated by ultrafast computed tomography. Am J Cardiol. 1992;70:977-80.
Haberl R, Becker A, Leber A. Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: results of 1764 patients. J Am Coll Cardiol. 2001;37:451-7.
Wong MD, Anthony BV, Abrahmson D. Detection of coronary calcium by ultrafast CT and its relation to clinical evidence of coronary artery disease. Am J Cardiol. 1994;73:223-7.
Raggi P, Callister TQ, Coil B. Identification of patients at increased risk of first unheralded AMI by EBCT. Circ. 2000;101:850-5.
Arad Y, Spadaro L, Goodman K. Prediction of coronary events with electron beam coronary tomography. J Am Coll Cardiol. 2000;36:1253-60.
Janowitz WR, Agatston AS, Kaplan G. Differences in prevalence and extent of coronary artery calcium detected by ultrafast CT in asymptomatic men and women. Am J Cardiol. 1993;72:247-54.
Eggen DA, Strong JP, Mcgill HC. Coronary calcification: relationship to clinically significant coronary lesions and race, sex and topographic distribution. Circ. 1965;32:948-55.