Progression of coronary artery calcification in asymptomatic individuals with pre-existing calcium score.

AIM: Coronary artery calcification (CAC) has been introduced as a reliable, non-invasive marker of atherosclerosis. In this retrospective study, we investigated the progression of CAC using electron beam computed tomography. METHODS: The study enrolled 598 individuals (521 males; mean age: 59.3±8.3 years) with initial CAC score (CACS) ≥10. The mean interscan period was 2.4±1.35 years (range: 1-7 years). The mean CACS, for the entire cohort, was 262.4±423.9 at baseline scan and 380.3±547.6 at follow-up. The mean annualized progression in CACS was 57.7±123.7; 47.4±66.5 in females and 58.3±128.1 in males (P=0.46). The mean annualized progression in CACS was 39.6±61.3 in individuals <60 years and 75.7±161.5 in individuals >60 years (P=0.0003). In multivariate analysis, only baseline CACS (P<0.0001) and smoking (P=0.002) were independently associated with the annual change in CACS.

Coronary artery calcification progression in asymptomatic individuals with initial score of zero.

The aim of this study is to determine the progression of coronary artery calcification (CAC) using electron beam computed tomography (CT) when the initial CAC score (CACS) is zero and to determine the best interval to repeat a CAC scan. We studied 388 individuals with zero CACS (308 males; mean age: 48.8 ± 8.26 years) who underwent 2 consecutive CT scans in a period of at least 12 months apart. The interscan period was 2.99 ± 1.35 years (range: 1-6 years). Three-quarters of the individuals (75%) did not develop any CAC progression, 20.87% presented CAC progression of 1 to 10, 3.6% had 11 to 50, whereas only 0.51% had >50. The average time of new CAC development was 4.2 ± 1.1 years. Individuals with CAC progression presented higher incidence of hypertension, diabetes mellitus, hypercholesterolaemia and higer frequency of male gender than those with without CAC changes (p<0.02). No cardiac events occurred during the follow-up period.

Aggressive and diffuse coronary calcification in South Asian angina patients compared to Caucasians with similar risk factors.

BACKGROUND: Ethnic differences in prevalence and severity of coronary artery disease are well established and are usually attributed to risk factors variation. This study investigates the differences in coronary artery narrowing and coronary calcification between two age- and gender-matched cohorts of South Asian and Caucasian symptomatic angina patients. METHODS: We identified 101 symptomatic angina patients of South Asian origin who had undergone CT angiography and calcium scoring, and compared them with 101 age and gender matched Caucasian patients. RESULTS: South Asians had a greater mean number of arterial segments with both obstructive and non-obstructive plaque than Caucasians (p=0.006 and p=0.0003, respectively) and higher prevalence of triple-vessel disease (p=0.0004). Similarly, South Asians had a higher mean CAC score (p<0.0001) and the percentage of South Asians with CAC>0 and in all categories of CAC score 100-1000 were also higher, as was the number of arterial segments with calcified and non-calcified plaque. These results were more marked in patients aged >50 but in those ≤ 50, Caucasians showed a higher mean number of diseased segments (p=0.019), with non-obstructive plaque (p=0.02), possibly suggesting that Caucasians are likely to have more diffuse atherosclerosis at an earlier age. CAC prevalence and severity in this age-group were not significantly different between South Asians and Caucasians. CONCLUSION: Despite similar conventional risk factors for CAD, symptomatic South Asians seem to have more aggressive and diffuse arterial calcification compared to Caucasians. These differences are more profound above the age of 50, suggesting potential genetic or other risk factors yet to be determined.

Differences in clinical profile of individuals with severe and markedly elevated coronary artery calcification detected by electron beam computed tomography.

Although several studies have demonstrated the association between coronary artery calcification (CAC) and coronary artery disease events, the underlying mechanism has not been fully elucidated. Furthermore, extensive CAC still remains a poorly understood phenomenon. The objective of this study is to determine the clinical characteristics and differences between 831 asymptomatic individuals with very high CAC scores (CACS ≥ 1000) and 497 asymptomatic individuals with CAC scores of 400 to 999. Individuals with CACS ≥ 1000 were more likely to have hypertension ([HTN]; P = .0004), hypercholesterolemia (P = .0001), diabetes mellitus ([DM] P = .005), and high body mass index ([BMI]; P = .03) compared with individuals with CACS = 400-999. On multivariable analysis, age (P < .0001) and BMI (P = .01) were found to be significant risk factors for the presence of very high CAC. While for males, age (P < .0001), hypercholesterolemia (P = .001), DM (P = .002), and obesity (P = .003) were independent risk factors; in females only HTN (P = .04) was independent risk factor.