Mandatory Reporting of Coronary Artery Calcifications Incidentally Noted on Chest Multi-Detector Computed Tomography: A Multicentre Experience
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Published:2018-11-16
Issue:1
Volume:17
Page:92-98
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ISSN:1570-1611
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Container-title:Current Vascular Pharmacology
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language:en
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Short-container-title:CVP
Author:
Cappabianca Salvatore1, Belfiore Maria Paola1, Reginelli Alfonso1, Capasso Raffaella2, Del Prete Alessandra1, Petrillo Mario1, Mascia Paola1, Rossi Claudia1, Romano Francesco3, De Filippo Massimo4, Scialpi Michele5, Gragnano Felice6, Calabrò Paolo6, Belfiore Giuseppe7, Brunese Luca2, Grassi Roberto1, Rotondo Antonio1
Affiliation:
1. Department of Clinical and Experimental Medicine, , Italy 2. Department of Medicine and Health Sciences, University of Molise, 86100, Campobasso, Italy 3. Department of Mental and Physical Health and University of Campania , Italy 4. Department of Clinical Sciences, Section of Radiological Sciences, University Hospital of Parma, 43100, Parma, Italy 5. Department of Surgical, Radiological and Odontostomatological Sciences, Division of Radiology 2, Perugia University, S. Maria della Misericordia Hospital, 06134, Perugia, Italy 6. Department of Cardiothoracic and Respiratory Sciences, University of Campania , Italy 7. Department of Diagnostic Imaging, , Italy
Abstract
Background: Coronary Artery Calcifications (CACs) are associated with coronary atherosclerosis
and Cardiovascular (CV) events. In “non-cardiovascular” settings, CACs can be easily detected
on chest Multi-Detector Computed Tomography (MDCT). Their evaluation may help to better
stratify CV risk in the general population, especially for primary prevention.
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Aims: We retrospectively evaluated the relationship between CAC distribution and CV risk, determined
by Framingham Risk Score (FRS), in a cohort of patients who underwent chest MDCT performed for
several clinical indications.
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Method: We retrospectively recruited 305 patients (194 men, 111 women; mean age 70.5 years) from 3
different Italian centres. Patients with coronary stent, pacemaker and/or CV devices were excluded from
the study. Circumflex Artery (LCX), Left Main Coronary Artery (LMCA), left Anterior Descending
artery (LAD) and right coronary artery (RCA) were analysed.
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Results: From a total population of 305 patients, 119 (39%) had low FRS (<10%), 115 (38%) had intermediate
FRS (10-20%), and 71 (23%) had high FRS (>20%). The study identified 842 CACs located
in decreasing order as follows: RCA (34.5%), LAD (32.3%), LCX (28%) and LMCA (13%). Statistical
two-step analysis subdivided patients into two clusters according to FRS (risk threshold = 12.38%):
cluster I (mean 9.34) and cluster II (mean 15.09). A significant association between CAC distribution
and cluster II was demonstrated. CACs were mostly detected in patients with intermediate FRS. All
patients (100%) with the highest CV risk showed intermediate RCA and LMCA involvement.
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Conclusion: Radiologists can note the distribution of CACs on a chest MDCT and should mandatorily
record them in their reports. Depending on CAC presence and location, these findings may have important
clinical implications, mostly in asymptomatic patients with intermediate FRS. This information may
reclassify a patients’ CV risk and improve clinical management.
Publisher
Bentham Science Publishers Ltd.
Subject
Cardiology and Cardiovascular Medicine,Pharmacology
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