Association of abdominal aortic calcium with coronary artery calcium and obstructive coronary artery disease: a pilot study

Abstract

This study sought to determine the association of abdominal aortic calcium (AAC) with coronary artery calcium (CAC) and obstructive coronary artery disease (CAD). We included 58 patients (mean age 54.4 years, 40% males) without known CAD who underwent a non-contrast abdominal computed tomography (CT) scan and 64-slice coronary computed tomography angiography (CCTA) within 2 years. A total AAC score using Agatston method was calculated in the abdominal aorta from the takeoff of the celiac artery to the aortic bifurcation. A total of 43/58 patients had AAC. Patients with AAC were older with no differences in other baseline characteristics. None of the patients with a zero AAC score had obstructive CAD. Thus, an AAC score of zero had a 100% negative predictive value (NPV) and 23% positive predictive value (PPV) for the detection of obstructive CAD and an 80% NPV and 79% PPV for detection of any coronary plaque. Using multivariate linear regression, AAC score was an independent predictor of CAC score after adjusting for age (P < 0.001). In our analysis, AAC score correlates with CAC score and has a high NPV to rule out CAD. The absence of AAC may help exclude obstructive coronary disease and improve the selection of patients that may benefit from further risk stratification.

Correlations Between Aortic Root Calcification and Coronary Artery Atherosclerotic Markers Assessed Using Multidetector Computed Tomography

“…Finally, several investigators have reported a strong correlation between a zero calcium score in the thoracic and abdominal aorta and the absence of coronary artery stenosis. Thus, patients with a zero calcium score in the aorta have a 100% negative predictive value for detection of stenotic coronary vessels (27,28).…”

Abdominal Aorta Dilatation and Cardiovascular Outcomes

“…Is this in part mediated by a greater burden of atherosclerosis and hypertension? The extent of the abdominal aorta calcification has been shown to be a marker of coronary atherosclerosis, 16 its progression, 17 and also associated with greater incidence of cardiovascular events. 18 Would it be possible that individuals with both dilatation and calcification of the abdominal aorta would be at even a greater cardiovascular risk than having either condition alone?…”

New and Evolving Concepts in CT for Abdominal Vascular Imaging

“…For example, CT-and MR imaging-based parameters such as vessel lumen caliber, calcium score, and plaque burden and character (noncalcified, calcified, or mixed) have now been put into clinical use (47)(48)(49)(50)(51)(52).…”

“…Coronary artery calcification scoring is based on the principle that higher degrees of calcification are indicative of more severe disease and therefore have a higher risk for development of a cardiac event (48,50). Since atherosclerosis is a systemic disease, absence of calcification in the abdominal aorta has a high negative predictive value for ruling out coronary artery disease (50).…”

“…Since atherosclerosis is a systemic disease, absence of calcification in the abdominal aorta has a high negative predictive value for ruling out coronary artery disease (50). The principles of DECT can be extended to quantifying aortic calcification by applying the material decomposition approach (49).…”