Aortic arch calcification is strongly associated with coronary artery calcification

We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low- and high-risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC). Consecutive patients who were referred for a...

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Bibliographic Details
Published in:	VASA Vol. 44; no. 2; p. 106
Main Authors:	Adar, Adem, Erkan, Hakan, Gokdeniz, Tayyar, Karadeniz, Aysegul, Cavusoglu, Ismail G, Onalan, Orhan
Format:	Journal Article
Language:	English
Published:	Switzerland 01-03-2015
Subjects:	Adult Aged Aged, 80 and over Aorta, Thoracic - diagnostic imaging Aortic Diseases - complications Aortic Diseases - diagnostic imaging Aortography - methods Area Under Curve Chi-Square Distribution Coronary Artery Disease - complications Coronary Artery Disease - diagnostic imaging Coronary Vessels - diagnostic imaging Female Humans Logistic Models Male Middle Aged Multidetector Computed Tomography Multivariate Analysis Odds Ratio Predictive Value of Tests Prospective Studies Risk Factors ROC Curve Severity of Illness Index Vascular Calcification - complications Vascular Calcification - diagnostic imaging computed tomography chest radiography coronary artery calcification Aortic arch calcification
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Summary:	We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low- and high-risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC). Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64-slice MDCT scanner for the evaluation of CAC score. A four-point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior-anterior chest radiography images. The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of ≥ 2 was the strongest independent predictor of a high-risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of ≥ 100 (AUC = 0.892, P < 0.0001), and ≥ 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of ≥ 2 predicted a CAC score of ≥ 400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively. AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low- and high-risk CAC scores.
ISSN:	0301-1526
DOI:	10.1024/0301-1526/a000415