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Diagnostic and Prognostic Value of Coronary Computed Tomography Angiography in Patients with Severe Calcification

Journal of Cardiovascular Translational Research volume 14, pages 131–139 (2021)Cite this article

Abstract

Our aim was to analyze its diagnostic and prognostic value in patients with high coronary calcium score (CCS). A total of 113 patients with CCS > 400 were included. Significant coronary artery disease (CAD) was defined as stenosis ≥ 50%. Invasive coronary angiography and major cardiovascular events were recorded. The CCS and heart rate during the acquisition were significantly lower in the diagnostic coronary computed tomography angiography (CCTA) group. The cut-off value of CCS to establish the diagnostic utility of CCTA was 878. The rate of cardiovascular events was 9.3%. The positive predictive value of CCTA to detect significant CAD was 73.5% and the negative predictive value for predicting cardiovascular events was 96%. In patients with high CCS, CCTA is useful to evaluate CAD, especially when the CCS is lower or equal to 878; moreover, the prognostic value of CCTA is better in patients where significant CAD has been ruled out.

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Abbreviations

CCTA:

Coronary computed tomography angiography

CCS:

Coronary calcium score

CAD:

Coronary artery disease

CADs:

Significant coronary artery disease

CVRF:

Cardiovascular risk factors

SD:

Standard deviation

MACEs:

Major adverse cardiovascular events

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Acknowledgments

Laura Fernández-Friera was acknowledged for her work in the follow-up of patients.

Funding

This study was supported by Comunidad de Madrid through the programme AORTASANA-CM; B2017/BMD-3676 co-financed by the European Social Fund (ESF).

Author information

Affiliations

  1. Unidad de Imagen Cardiaca, Departamento de Cardiología, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain

    Belén Díaz-Antón, Jorge Solís, Beatriz López-Melgar, Patricia Barrio, Andrea Moreno & Leticia Fernández-Friera

  2. Universidad CEU San Pablo, Madrid, Spain

    Belén Díaz-Antón, Jorge Solís, Beatriz López-Melgar & Leticia Fernández-Friera

  3. Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain

    Jorge Solís, Beatriz López-Melgar, Andrea Moreno & Leticia Fernández-Friera

  4. CIBER de enfermedades CardioVasculares (CIBERCV), Madrid, Spain

    Jorge Solís & Leticia Fernández-Friera

  5. Departamento de Teoría de la Señal y Comunicaciones, Universidad Carlos III de Madrid, Madrid, Spain

    Roberto Díaz Morales

  6. Departamento de I+D, Tree Technology, Madrid, Spain

    Roberto Díaz Morales

  7. Servicio de Hemodinámica y Cardiología Intervencionista, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain

    Leire Unzué & Eulogio García

  8. Departamento de Cardiología, Hospital Nuestra Señora del Rosario, Madrid, Spain

    Antonio Alvarez-Vieitez

  9. Departamento de Cardiología, HM Hospitales-Centro Integral de Enfermedades Cardiovasculares HM CIEC, Madrid, Spain

    Juan Medina & Francisco Javier Parra Jiménez

Authors
  1. Belén Díaz-Antón
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  2. Jorge Solís
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  3. Roberto Díaz Morales
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  4. Beatriz López-Melgar
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  6. Andrea Moreno
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  7. Leire Unzué
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  9. Juan Medina
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  10. Eulogio García
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  11. Francisco Javier Parra Jiménez
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  12. Leticia Fernández-Friera
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Corresponding author

Correspondence to Leticia Fernández-Friera.

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Conflict of Interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Clinical Relevance of the Manuscript

We have shown that CCTA is useful for evaluating CAD in almost 90% of patients with extensive coronary calcification, especially if the CCS is lower or equal to 878 and the heart rate is optimized. Cardiovascular events are lower when CCTA excluded CADs, which provides prognostic value in the medium term. Thus, a high CCS should, therefore, not be considered as a contraindication for CCTA.”

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Díaz-Antón, B., Solís, J., Morales, R.D. et al. Diagnostic and Prognostic Value of Coronary Computed Tomography Angiography in Patients with Severe Calcification. J. of Cardiovasc. Trans. Res. 14, 131–139 (2021). https://doi.org/10.1007/s12265-020-09977-4

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Keywords

  • Coronary calcium score
  • Non-invasive coronary angiography
  • Coronary computed tomography angiography