Clinical and angiographic profile of patients with markedly elevated coronary calcium scores (>or=1000) detected by electron beam computed tomography.
OBJECTIVE
The objective of this study was to determine the clinical and angiographic profile of patients with extremely high coronary artery calcium scores (CACS; >or=1000) by electron beam computed tomography (EBCT).


METHODS
All patients at Rush University Medical Center who had a calcium score >or=1000 and a coronary angiogram performed from 1997 to 2002 were identified using a prospectively collected database. The baseline demographics, symptom status, and degree of coronary stenosis by angiography and subsequent rate of coronary intervention were compared with that of patients with calcium scores <1000.


RESULTS
The clinical and angiographic profile of patients with severe coronary calcification, detected by EBCT, revealed that patients with scores >or=1000 had a significantly higher prevalence of coronary stenosis >or=50% compared with patients with scores <1000 (97% vs. 57%, P<.001). The group with CACS >or=1000 was more likely to be male (90% vs. 75%, P=.027) and was older (64+/-8 vs. 59+/-10, P=.001) compared with the group with less severe calcification. Although there was a significantly higher rate of luminal stenosis detected by coronary angiography in the cohort with CACS >or=1000, there was no difference in subsequent percutaneous coronary intervention (PCI) and utilization of intracoronary stents between the two groups.


CONCLUSIONS
A markedly elevated coronary calcium score (>or=1000) is correlated with increasing age and is associated with an increased likelihood of coronary stenosis >or=50%. However, the decision to perform coronary angiography in patients with severe coronary calcification should not be based solely on these findings, but should remain primarily dependent on the degree of ischemia detected by clinical and functional assessment.
Almeda
Francis Q
FQ
Rush University Medical Center, Chicago, IL, USA. falmeda@aol.com
Shah
Rima
R
Senter
Shaun
S
Kason
Thomas T
TT
Haynie
Justin
J
Calvin
James E
JE
Kavinsky
Clifford J
CJ
Snell
R Jeffrey
RJ
Schaer
Gary L
GL
McLaughlin
Vallerie V
VV
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000628:therapy; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome