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CT-based abdominal aortic calcification score as a surrogate marker for predicting the presence of asymptomatic coronary artery disease

  • Gastrointestinal
  • Published:
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Abstract

Objectives

To assess the value of a CT-based abdominal aortic calcification (AAC) score as a surrogate marker for the presence of asymptomatic coronary artery disease (CAD).

Methods

The AAC scores of 373 patients without cardiac symptoms who underwent both screening coronary CT angiography and abdominal CT within one year were calculated according to the Agatston method. Logistic regression was used to derive two multivariate models from traditional cardiovascular risk factors, with and without AAC scores, to predict the presence of CAD. The AAC score and the two multivariate models were compared by calculating the area under the receiver operating characteristic curve (AUC) and the net reclassification improvement (NRI).

Results

The AAC score alone showed a marginally higher AUC (0.823 vs. 0.767, P = 0.061) and significantly better risk classification (NRI = 0.158, P = 0.048) than the multivariate model without AAC. The multivariate model using traditional factors and AAC did not show a significantly higher AUC (0.832 vs. 0.823, P = 0.616) or NRI (0.073, P = 0.13) than the AAC score alone. The optimal cutoff value of the AAC score for predicting CAD was 1025.8 (sensitivity, 79.5 %; specificity, 75.9 %).

Conclusions

AAC scores may serve as a surrogate marker for the presence or absence of asymptomatic CAD.

Key Points

• Severe vascular calcification indicates a high probability of coronary artery disease.

• Vascular calcification in the abdominal aorta can be quantified by computed tomography.

• Abdominal CT could lead to early detection of asymptomatic coronary artery disease.

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Abbreviations

CAD:

coronary artery disease

CAC:

coronary artery calcification

AAC:

abdominal aortic calcification

CCTA:

coronary CT angiography

ROC:

receiver operating characteristic

NRI:

net reclassification improvement

AUC:

area under the curve

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Acknowledgments

The scientific guarantor of this publication is Myeong-Jin Kim. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Approval from the institutional animal care committee was not required because this study did not involve animal subjects. None of our study subjects or cohorts had been previously reported. This is a retrospective cross-sectional study performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, Korea

    Chansik An, Hye-Jeong Lee, Sung Soo Ahn, Byoung Wook Choi, Myeong-Jin Kim & Yong Eun Chung

  2. Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Korea

    Hye Sun Lee

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  1. Chansik An
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  2. Hye-Jeong Lee
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Correspondence to Yong Eun Chung.

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An, C., Lee, HJ., Lee, H.S. et al. CT-based abdominal aortic calcification score as a surrogate marker for predicting the presence of asymptomatic coronary artery disease. Eur Radiol 24, 2491–2498 (2014). https://doi.org/10.1007/s00330-014-3298-3

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  • DOI: https://doi.org/10.1007/s00330-014-3298-3

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