Abstract 18710: Spotty Calcifications in Coronary Arteries - What Does it Reflect?
Introduction: Previous studies have documented that the presence of “spotty” calcification in coronary plaques is associated with a higher likelihood of developing acute coronary syndrome (ACS). On the other hand, plaques responsible for stable angina are more calcified than plaques responsible for ACS. The risk of coronary heart disease and mortality increase with increasing total coronary artery calcium scores determined by non-contrast computed tomography (CT). However, the relationship between the pattern of calcification and the morphological features of the plaque remains largely unknown.
Aim: To examine the relationship between radiological and morphological features of coronary atherosclerotic plaques obtained postmortem.
Methods: We collected 17 coronary arteries from forensic autopsies. The arteries were scanned using a cabinet x-ray system and CT. Up to 12 sites in each artery, with and without calcification, were selected, and processed for plastic embedding and microscopic examination with preserved calcium. Spotty calcification was defined as the presence of a calcified lesions ≤2.5mm in diameter length. Dense calcification was defined as a calcified lesion >2.5mm.
Results: The frequency of fibroatheromas was significantly higher in sections with spotty calcification than in sections with dense calcification (spotty: 57.1% versus dense; 7.3%, p= <0.0001). 29 out of 36 sections containing fibroatheromas presented with spotty calcification on X-ray examination, and 4 sections presented with dense calcification (spotty: 80.6% versus dense: 11.1%, p= <0.0001). Spotty calcifications were located in necrotic cores or in lipid pools (67.4%). Dense calcifications were located in the connective tissue of plaques (58.5%, p= 0.0192).
Conclusion: The pattern of calcification visualized by x-ray scans and plaque morphology correlated. Spotty calcifications were often localized within lipid pools or necrotic cores. Calcifications with X-ray defined spotty appearance were associated with fibroatheromas.
- Coronary artery calcification (CAC)
- Coronary artery disease
- Computed tomography
Author Disclosures: E. Espeseth: None. O. Hansen: None. R. Ullerup: None. J. Thygesen: None. A. Charles: None. E. Falk: None.
- © 2014 by American Heart Association, Inc.