Abstract 14540: Relationship and Prognostic Value of Aortic Arch Calcification on Chest X-Ray and Coronary Artery Calcium Score on Multi-Detector Computed Tomography
Background: Coronary artery calcium (CAC) score and aortic arch calcification (AAC) each individually are associated with cardiovascular disease and outcomes.
Objective: This study investigated the relationship and ability of CAC and AAC to predict coronary artery disease and cardiovascular disease events.
Methods: A total of 2,031 stable angina patients with chest X-ray and cardiac computed tomography (CT) scan were followed up for 4 years for a major adverse cardiac or cerebrovascular event (i.e., death from any cause, stroke, myocardial infarction, or repeat revascularization). The extent of AAC on a postero-anterior plain chest X-ray was divided into four grades (0 to 3).
Results: Median Framingham risk score was 5 and 123 (6%, 1 death, 5 stroke, 6 myocardial infarction, and 111 repeat revascularization) adverse events were occurred. A Progressively higher grade of AAC was associated with a higher CAC score (p < 0.0001). AAC grade 2 and 3 was associated with an increased risk of adverse events (odds ratio (OR) 2.41, 95% confidence interval (CI) 1.33-4.36, P= 0.004). Using receiver operating characteristic analysis, CCA score ≥ 28 (AUC=0.67, sensitivity=63%, specificity=64%) was a significant predictor of adverse events (OR 3.20, 95% CI 2.23-4.59). Gradually increasing risk of adverse events could be noted according to CAC score and AAC grade (Figure). Cox regression, adjusted for Framingham risk score, showed only CAC score is associated with adverse events (OR 2.73, 95% CI 1.86-4.02).
Conclusions: Although CAC and AAC are strongly correlated, CAC, not AAC, is independent predictor of adverse events. In patients with similar CAC score, AAC is associated with increasing risk, suggesting that careful attention should be given to the presence of AAC in a simple X-ray.
- © 2013 by American Heart Association, Inc.