Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT.
OBJECTIVE
To compare underlying calcific atherosclerotic lesions in acute versus chronic coronary events in patients with hypertension by using dual-sector spiral computed tomography (CT).


METHODS
Eight hundred eighty-four calcific lesions were analyzed in a cohort of 50 patients (39 men, 11 women; age range, 55-79 years; mean age, 66 years +/- 6 [SD]) with hypertension who sustained a coronary event during 3-year follow-up. All underwent dual-sector spiral CT within 12 months before the event. Twenty-nine patients had an acute event (acute group): acute myocardial infarction, 20; unstable angina pectoris, six; acute ischemia, two; sudden death, one. Twenty-one patients had chronic manifestations of obstructive coronary disease (chronic group): severe stable angina, five; angiographically identified disease, 12; disease requiring angioplasty, two; and disease requiring bypass surgery, two. To examine differences between the two study groups, the chi(2) or Fisher exact test was applied to categorical parameters and the two-sample t test or Wilcoxon rank sum test to quantitative parameters.


RESULTS
High prevalence of coronary calcium (total coronary calcium score [TCS] >0) was observed in both groups: 93% (27 of 29) in the acute and 95% (20 of 21) in the chronic group. There were 518 lesions in the chronic and 366 in the acute group, with a median number of 35 and nine lesions per patient, respectively (P <.001). The median TCS was 906 for the chronic and 63 for the acute group (P <.01).


CONCLUSIONS
A mild degree of calcification characterizes patients with acute coronary events, while diffuse high-attenuation calcific plaques are associated with chronic coronary events.
Shemesh
Joseph
J
Cardiac Rehabilitation Institute, Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel-Hashomer, 52621, Israel. dshemesh@netvision.net.il
Apter
Sara
S
Itzchak
Yacov
Y
Motro
Michael
M
D000208:Acute Disease; D000368:Aged; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D036542:Tomography, Spiral Computed