Clinical significance of calcification in ascending aorta as a marker for the requirement of coronary revascularization

Abstract

Aim: Vascular or valvular calcification is a manifestation of atherosclerosis. The aim of this study was to clarify the association between calcification in the vascular or valvular area and significant coronary stenosis; that is, the requirements of coronary revascularization (CR), and to analyze the most associated marker among those valuables. Methods and Results: A total of 253 consecutive patients underwent multi-detector spiral computed tomography (MDCT) to diagnose coronary artery stenosis. We quantitatively and qualitatively analyzed calcification in vascular (coronary artery, thoracic ascending and descending aorta) and valvular (mitral and aortic valve) areas. Of 253 patients, 56 with suspected coronary artery stenosis or who had heavy calcification that precluded a diagnosis of lumen stenosis underwent selective coronary angiography. Coronary artery stenosis was significant in 47 patients, of whom 40 underwent CR. The calcification score revealed a significant association between any two sites. Univariate analysis revealed that CR patients showed significantly more calcification at sites other than the aortic valve and a significantly higher calcium score at 3 vascular beds. Multivariate analysis revealed that the presence of calcification in the ascending aorta and a calcium score >103.8, a cut-off value determined by receiver-operating characteristics (ROC) curve analysis, for the coronary artery were independent factors for CR. Conclusions: Calcification at sites other than the aortic valve was significantly related to CR (+). The presences of calcification in the ascending aorta and a calcium score >103.8 for the coronary artery were independently associated with CR.