Cargando…

What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry

AIM: This prospective study was conducted to evaluate the incidence and predictors of coronary artery disease (CAD) in relation to the low coronary artery calcium (CAC) score among patients with intermediate probability of CAD. MATERIAL AND METHODS: A total of 1132 consecutive patients were included...

Descripción completa

Detalles Bibliográficos
Autores principales: Kaczmarska, Edyta, Kępka, Cezary, Dzielińska, Zofia, Pracoń, Radosław, Kryczka, Karolina, Petryka, Joanna, Pręgowski, Jerzy, Kruk, Mariusz, Demkow, Marcin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915948/
https://www.ncbi.nlm.nih.gov/pubmed/24570687
http://dx.doi.org/10.5114/pwki.2013.34024
_version_ 1782302639542763520
author Kaczmarska, Edyta
Kępka, Cezary
Dzielińska, Zofia
Pracoń, Radosław
Kryczka, Karolina
Petryka, Joanna
Pręgowski, Jerzy
Kruk, Mariusz
Demkow, Marcin
author_facet Kaczmarska, Edyta
Kępka, Cezary
Dzielińska, Zofia
Pracoń, Radosław
Kryczka, Karolina
Petryka, Joanna
Pręgowski, Jerzy
Kruk, Mariusz
Demkow, Marcin
author_sort Kaczmarska, Edyta
collection PubMed
description AIM: This prospective study was conducted to evaluate the incidence and predictors of coronary artery disease (CAD) in relation to the low coronary artery calcium (CAC) score among patients with intermediate probability of CAD. MATERIAL AND METHODS: A total of 1132 consecutive patients were included in the analysis (58.7 ±10.9 years, 46.7% males). Coronary computed tomography (CCT) angiography was performed in a multi-detector computed tomography scanner. Coronary artery calcium score was calculated by the Agatston method. Obstructive CAD was defined as the presence of coronary artery stenosis ≥ 50% on CCT angiography. RESULTS: Coronary artery disease was diagnosed in nearly one-fourth of patients (n = 272, 24%). In the receiver operating characteristics (ROC) curve analysis a CAC score of 10 was used as an optimal cut-off point for discriminating obstructive CAD (sensitivity: 0.79, specificity: 0.75, p < 0.0001) whereas for a CAC score of 100 the sensitivity and specificity were 0.48 and 0.92, respectively. On multivariate analysis after adjustment for age, gender, hypertension, hyperlipidemia, creatinine levels, only in patients with CAC score ≤ 10 age (OR = 1.05, 95% CI: 1.02-1.08, p = 0.0005, OR = 1.05, 95% CI: 1.03-1.08, p < 0.0001) and male gender (OR = 3.45, 95% CI: 1.92-6.22, p < 0.0001), likewise in group with CAC score ≤ 100 age (OR = 1.05, 95% CI: 1.03-1.08, p < 0.0001) and male gender (OR = 3.31, 95% CI: 1.88-5.81, p < 0.0001) were independent predictors of obstructive CAD. CONCLUSIONS: The cut-off point of 10 for CAC score determined patients with CAD with the best sensitivity and specificity. Therefore, a total CAC score < 10 should be classified as “low”. In patients with a low CAC score obstructive high risk plaques prone to rupture are presented and are associated with increasing age and male gender.
format Online
Article
Text
id pubmed-3915948
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Termedia Publishing House
record_format MEDLINE/PubMed
spelling pubmed-39159482014-02-25 What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry Kaczmarska, Edyta Kępka, Cezary Dzielińska, Zofia Pracoń, Radosław Kryczka, Karolina Petryka, Joanna Pręgowski, Jerzy Kruk, Mariusz Demkow, Marcin Postepy Kardiol Interwencyjnej Original Paper AIM: This prospective study was conducted to evaluate the incidence and predictors of coronary artery disease (CAD) in relation to the low coronary artery calcium (CAC) score among patients with intermediate probability of CAD. MATERIAL AND METHODS: A total of 1132 consecutive patients were included in the analysis (58.7 ±10.9 years, 46.7% males). Coronary computed tomography (CCT) angiography was performed in a multi-detector computed tomography scanner. Coronary artery calcium score was calculated by the Agatston method. Obstructive CAD was defined as the presence of coronary artery stenosis ≥ 50% on CCT angiography. RESULTS: Coronary artery disease was diagnosed in nearly one-fourth of patients (n = 272, 24%). In the receiver operating characteristics (ROC) curve analysis a CAC score of 10 was used as an optimal cut-off point for discriminating obstructive CAD (sensitivity: 0.79, specificity: 0.75, p < 0.0001) whereas for a CAC score of 100 the sensitivity and specificity were 0.48 and 0.92, respectively. On multivariate analysis after adjustment for age, gender, hypertension, hyperlipidemia, creatinine levels, only in patients with CAC score ≤ 10 age (OR = 1.05, 95% CI: 1.02-1.08, p = 0.0005, OR = 1.05, 95% CI: 1.03-1.08, p < 0.0001) and male gender (OR = 3.45, 95% CI: 1.92-6.22, p < 0.0001), likewise in group with CAC score ≤ 100 age (OR = 1.05, 95% CI: 1.03-1.08, p < 0.0001) and male gender (OR = 3.31, 95% CI: 1.88-5.81, p < 0.0001) were independent predictors of obstructive CAD. CONCLUSIONS: The cut-off point of 10 for CAC score determined patients with CAD with the best sensitivity and specificity. Therefore, a total CAC score < 10 should be classified as “low”. In patients with a low CAC score obstructive high risk plaques prone to rupture are presented and are associated with increasing age and male gender. Termedia Publishing House 2013-03-21 2013 /pmc/articles/PMC3915948/ /pubmed/24570687 http://dx.doi.org/10.5114/pwki.2013.34024 Text en Copyright © 2013 Termedia http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Paper
Kaczmarska, Edyta
Kępka, Cezary
Dzielińska, Zofia
Pracoń, Radosław
Kryczka, Karolina
Petryka, Joanna
Pręgowski, Jerzy
Kruk, Mariusz
Demkow, Marcin
What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry
title What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry
title_full What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry
title_fullStr What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry
title_full_unstemmed What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry
title_short What is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? Multi-Detector Computed Tomography ANIN Registry
title_sort what is the optimal cut-off point for low coronary artery calcium score assessed by computed tomography? multi-detector computed tomography anin registry
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3915948/
https://www.ncbi.nlm.nih.gov/pubmed/24570687
http://dx.doi.org/10.5114/pwki.2013.34024
work_keys_str_mv AT kaczmarskaedyta whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT kepkacezary whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT dzielinskazofia whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT praconradosław whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT kryczkakarolina whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT petrykajoanna whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT pregowskijerzy whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT krukmariusz whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry
AT demkowmarcin whatistheoptimalcutoffpointforlowcoronaryarterycalciumscoreassessedbycomputedtomographymultidetectorcomputedtomographyaninregistry