The relationship between carotid and coronary calcification in patients with coronary artery disease

Abstract

Background Atherosclerosis is a multi‐system pathology with heterogeneous involvement. We aimed to investigate the relationship between the presence and severity of carotid and coronary calcification in a group of patients with coronary artery disease. Methods Sixty‐three patients presenting with unstable angina or positive stress test for myocardial ischaemia were enrolled in this study. All patients underwent CT scanning of the carotid and coronary arteries using the conventional protocol and Agatston scoring system. Risk factors for atherosclerosis were also analyzed for correlation with the extent of arterial calcification. Results Total coronary artery calcium score (CAC) was several times higher than total carotid calcium score (1274 (1018) vs 6 (124), p = 0·0001, respectively). The left carotid calcium score correlated strongly with the right carotid calcium score (rho = 0·69, p < 0·0001). The total CAC score correlated modestly with the total carotid calcium score (rho = 0·34, p = 0·007), in particular with left carotid score (rho = 0·38, p = 0·002), but not with the right carotid score. The left coronary calcium score correlated with the right coronary calcium score (rho = 0·35, p = 0·004), left carotid calcium score (rho = 0·33, p = 0·007) and left carotid calcium score at the bifurcation (rho = 0·34, p = 0·006). While hypertension correlated with carotid calcium score, diabetes and dyslipidaemia correlated with left CAC score. Conclusion In patients with coronary disease, the carotid calcification pattern appeared to be similar between the right and left system in contrast to that of the coronary arteries. CAC correlated only modestly with the carotid score, despite being significantly higher. Hypertension was related to carotid calcium score while diabetes and dyslipidaemia correlated with coronary calcification.

Glioblastoma and Internal Carotid Artery Calcium Score: A Possible Novel Prognostic Partnership?

“…It should be noted that the evaluation of calcium in carotid arteries was performed by Gepner at al. using ultrasound instead of CT. More encouraging data corroborating our findings were achieved by Shenouda et al in 2021, who reported the results of a retrospective study carried out on 63 patients with unstable angina or positive stress test for myocardial ischaemia [25]. In these patients, the overall CACs showed a significant correlation with total carotid score (rho = 0.34, p = 0.007), particularly with the left carotid score (rho = 0.38, p = 0.002), while the correlation with the right carotid score was not statistically significant.…”

Vascular Calcification Heterogeneity from Bench to Bedside: Implications for Manifestations, Pathogenesis, and Treatment Considerations

“…The heterogeneity of VC can be easily appreciated from the arterial segments involved and inter-individual variations in severity. Studies have revealed that the prevalence of arterial calcification varies depending on the arterial segments, and a small-scale study showed that in the same group of older patients, carotid and coronary calcifications were present in 53.4% and nearly 100% of participants, respectively [25]. The distribution of calcification severity also tended to be more severe for coronary calcification, whose calcification scores could reach 10-fold higher than those for carotid calcification [25].…”

“…Human data showed that different arterial segments reacted differently with regard to their calcification susceptibility to air pollution, and a meta-analysis showed that fine particulate matter exposure correlated more closely with carotid arteriopathy than with coronary calcification [74]. The degree of coronary calcification was significantly associated with carotid calcification, but with side deviations (left > right) [25]. Interestingly, hypertension correlated with higher carotid calcification scores, whereas diabetes and dyslipidemia correlated with higher coronary calcification scores.…”

“…Studies have revealed that the prevalence of arterial calcification varies depending on the arterial segments, and a small-scale study showed that in the same group of older patients, carotid and coronary calcifications were present in 53.4% and nearly 100% of participants, respectively [25]. The distribution of calcification severity also tended to be more severe for coronary calcification, whose calcification scores could reach 10-fold higher than those for carotid calcification [25]. Razavi et al showed that at least one-third of older adults with severe aortic valve calcification, another form of cardiovascular calcification, did not have coronary artery calcification [26].…”

Assessment of Compatibility Between Cardiologists and Radiologists for Interpreting and Reporting Carotid Duplex Ultrasound Images

“…It is common in patients with coronary and peripheral artery diseases. 2 Cerebrovascular events due to carotid artery diseases are common in developed countries. 3 In clinical practice, imaging obtained using carotid duplex ultrasound (USG) is important in both the management of patients with acute stroke and the risk assessment of coronary artery disease or stroke.…”