title: Valvular and thoracic aortic calcium as a marker of the extent and severity of angiographic coronary artery disease.
abstract: BACKGROUND
  The presence of calcified extracoronary structures as a useful indicator of underlying coronary artery disease (CAD) has not yet been established. The purpose of this study was to evaluate whether valvular and thoracic aortic calcification is associated with obstructive CAD.
  
  
  METHODS
  We evaluated 99 patients who underwent both coronary angiography and electron beam tomography (EBT) coronary scanning. We identified the presence, absence, and amount of calcification in the aortic valve (AVC), mitral annulus (MAC), descending aorta (DAC), and ascending aorta (AAC). The extent of CAD was graded according to the number of vessels diseased (VD).
  
  
  RESULTS
  Patients with multivessel disease (MVD) had a higher proportion of DAC. The presence of DAC significantly increased the specificity of EBT to detect CAD (58% with a calcium score >0 to 88% for calcium score>0 and DAC >0, P <.001). Both AAC and DAC were associated with a significantly higher rate of MVD in women (DAC, 63% in MVD vs 19% without, P <.01.; AAC, 65% vs 22%, P <.05). MAC had no relationship to either stenosis severity or the presence of obstructive CAD. AVC was the strongest predictor of the severity of CAD and predicted the presence of 3-vessel disease.
  
  
  CONCLUSIONS
  AVC and thoracic aortic calcification as detected with EBT are associated with the angiographic extent and severity of CAD and add incremental diagnostic value to the coronary artery calcium score. MAC does not add incremental value.
authors.affiliation: Harbor-UCLA Research and Education Institute, Torrance 90502, USA.
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamamoto
authors.forename: David
authors.initials: D
authors.lastname: Shavelle
authors.forename: Junichiro
authors.initials: J
authors.lastname: Takasu
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.forename: Song Shou
authors.initials: SS
authors.lastname: Mao
authors.forename: Hans
authors.initials: H
authors.lastname: Fischer
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D005260:Female; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging*; D006351:Heart Valves / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed