Additional value of associating aortic valve calcification to coronary calcium as a gatekeeper for coronary tomography angiography

BMC Cardiovascular Disorders

Lino Gonçalves²  Marco Costa³  Susana Basso¹  Rui Catarino¹  Luís Paiva³  Rui Providência²  Ana Faustino³ 

[1] Radiology Department, Coimbra’s Hospital and University Centre – General Hospital, Coimbra, Portugal;Faculty of Medicine, University of Coimbra, Coimbra, Portugal;Cardiology Department, Coimbra’s Hospital and University Centre – General Hospital, 3041-801 S. Martinho do Bispo, Coimbra, Portugal

关键词: Coronary CT angiography;    Coronary artery disease;    Coronary artery calcification;    Cardiac computed tomography;    Aortic valve calcification;   

Others  :  1216784
DOI  :  10.1186/s12872-015-0058-5

 received in 2014-09-28, accepted in 2015-06-19,  发布年份 2015

【 摘 要 】

Background

Aortic valve calcification shares risk factors with coronary artery disease. Coronary calcium has been used has a gatekeeper to performing coronary tomography angiography. The aim of this study was to evaluate aortic valve calcification as a predictor of obstructive coronary artery disease by computed tomography, and its possible usefulness, alongside with coronary calcium, to improve the decision of whether or not to proceed with computed tomography angiography.

Methods

Transversal case–control study including 154 consecutive patients (62 ± 12 years, 57.6 % female, without known coronary or valve disease) undergoing calcium scoring and angiography through computed tomography (Phillips Brilliance, 16-slice). Predictors of aortic valve calcification and obstructive coronary artery disease were identified. Usefulness of aortic valve calcification when added to calcium score for prediction of obstructive coronary artery disease was assessed by binary logistic regression and net reclassification index.

Results

Aortic valve calcification was associated with higher coronary calcium, extent and prevalence of obstructive coronary disease, which was identified in 22.1 % of patients and was discriminated by aortic valve calcium with an area under curve 0.749 (p < 0.001, Youden index: 61). A higher discriminative power was achieved with a model based on coronary and aortic valve calcification (AUC 0.900, p < 0.001). Compared with calcium score >400 as a gatekeeper to angiography, the association of aortic calcium >61 allowed a net reclassification index of +7.7 % of patients.

Conclusions

Aortic valve calcification is associated with the prevalence and extent of obstructive coronary artery disease by computed tomography angiography and is an easy, fast and useful method to improve the selection of patients for angiography.

【 授权许可】

   
2015 Faustino et al.

【 图 表 】

Fig. 1.

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