Increased prevalence of coronary artery calcification in patients with suspected pulmonary embolism.
OBJECTIVE
The authors explored the possibility that patients with suspected pulmonary embolism are at high risk for coronary artery disease. To this purpose, they compared the presence of coronary artery calcification on computed tomography (CT) in patients suspected of pulmonary embolism with age- and gender-matched controls.


METHODS
The CT scans of 214 patients were reviewed. Of those, 107 consecutive patients (50%) had pulmonary CT angiography for suspected pulmonary embolism (PE group). The remaining 107 age- and gender-matched patients were scanned for reasons other than pulmonary embolism (non-PE group). All CT scans were performed with the same 8-detector-row multislice scanner. Two radiologists reviewed scans of 5-mm slices using a five-grade modified coronary calcium scoring system: 1 = no calcification; 2 = minimal calcification; 3 = mild calcification; 4 = moderate calcification; and 5 = severe calcification. The Marginal Homogeneity test was used to compare the distribution and severity of calcification in the two groups.


RESULTS
Of 107 patients in the PE group, seven (6.54%) had pulmonary embolism detected on CT. Coronary artery calcification was detected in 61 patients (57%) in the PE group compared with 42 patients (39%) in the non-PE group. The Marginal Homogeneity test showed that patients with pulmonary embolism symptoms were 2.9 times more likely to have calcification detected compared with those patients who had chest CT for some other reason (P = .0034). However, in patients in whom coronary artery calcification was detected, the distribution of severity of calcification was the same in both groups.


CONCLUSIONS
Assuming coronary artery calcification indicated coronary atherosclerosis, patients undergoing CT for suspected pulmonary embolism may be at high risk for coronary artery disease.
Kiryu
Shigeru
S
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA.
Raptopoulos
Vassilios
V
Baptista
Jovanna
J
Hatabu
Hiroto
H
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed