Aortic calcification on plain chest radiography increases risk for coronary artery disease.
OBJECTIVE
To determine whether an association exists between aortic calcification viewed on plain chest radiography and coronary artery disease.


METHODS
Retrospective review of all chest radiographs obtained from consecutive patients undergoing coronary angiography at a primary cardiac center during 1999. Plain chest radiographs were reviewed by blinded radiologists, and interobserver consistency was measured. The presence or absence of aortic arch calcification was abstracted and compared with the results of coronary angiography.


RESULTS
Of 654 cases, 329 of 360 patients with aortic arch calcification vs. 241 of 294 patients without aortic arch calcification had coronary artery disease demonstrated on angiography. The 9% absolute difference in proportions was significant (p = 0.0003). The relative risk (measured by risk ratio) was 1.11 (95% confidence interval, 1.05 to 1.19).


CONCLUSIONS
Several objective signs (e.g., hypertension, hyperlipidemia, and ECG changes) have been associated previously with the presence of coronary artery disease. This study further suggests an association between coronary disease and aortic arch calcification on plain chest radiography. These results may assist primary-care providers performing routine health assessments as well as emergency practitioners evaluating patients with potential angina.
Li
James
J
Division of Emergency Medicine, Harvard Medical School, Harvard University, Cambridge, MA, USA. jamesli@hms.harvard.edu
Galvin
Hannah K
HK
Johnson
Sandra C
SC
Langston
Charles S
CS
Sclamberg
Joy
J
Preston
Charles A
CA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012307:Risk Factors