Aortic atherosclerosis detected with electron-beam CT as a predictor of obstructive coronary artery disease.
OBJECTIVE
Several studies have demonstrated an association between coronary and aortic atherosclerosis. Aortic atherosclerosis is easily quantified by means of electron-beam computed tomography (CT). The aim of this study was to evaluate the usefulness of measurement of aortic atherosclerosis with electron-beam CT as an independent predictor of obstructive coronary artery disease (CAD).


METHODS
Ninety-seven patients (67 men, 30 women; mean age, 61 years +/- 12) were enrolled and underwent electron-beam CT with and without contrast material. Coronary artery calcification was quantified with nonenhanced electron-beam CT by means of Agatston score. CAD was defined as luminal narrowing of the coronary artery by at least 70%, as measured with electron-beam angiography. Aortic atherosclerosis was quantified by measuring raised lesions of the aortic wall (plaque) and wall thickening (volume and thickness) in the midportion of the descending thoracic aorta (10 contiguous sections), as depicted at contrast material-enhanced CT angiography.


RESULTS
Aortic plaque and calcification were detected only in patients who were at least 58 years old. The presence of aortic plaque was predictive of obstructive CAD, independent of coronary artery calcification. The sensitivity of aortic plaque (raised lesions) for obstructive CAD was 89% in patients at least 58 years old, and the specificity was 63%. Aortic calcification had a sensitivity of 56% and a specificity of 72% for diagnosis of obstructive CAD.


CONCLUSIONS
This study demonstrated that aortic plaque detected with contrast-enhanced electron-beam CT was a more consistent predictor of obstructive CAD than other independent aortic variables. Aortic calcification depicted on nonenhanced CT images was highly specific for obstructive CAD.
Takasu
Junichiro
J
Division of Cardiology, Harbor-UCLA Medical Center, Research and Education Institute, 1124 W Carson St, Bldg RB-2, Torrance, CA 90502-2064, USA.
Mao
Songshou
S
Budoff
Matthew J
MJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000473:pathology*; D001161:Arteriosclerosis / Q000175:diagnosis* / Q000453:epidemiology; D002114:Calcinosis / Q000175:diagnosis / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed