title: Coronary artery diameter related to calcium scores and coronary risk factors as measured with multidetector computed tomography: a substudy of the ACCURACY trial.
abstract: Arterial remodeling, an early change of atherosclerosis, can cause dilated arterial diameter. We measured coronary artery diameter with use of noncontrast 64-slice multidetector computed tomography (MDCT), and studied its association with coronary artery calcium levels and traditional coronary risk factors. We included 140 patients from the ACCURACY trial whose noncontrast MDCT images showed measurable coronary arteries. Using 3 measurements of left main coronary artery (LMCA) and right coronary artery (RCA) diameters within 3 mm of the ostium, we associated the results with traditional coronary risk factors and calcium scores. The prevalence of LMCA and RCA calcium was 22% and 51%, respectively. Mean arterial diameters were 5.67±1.18 mm (LMCA) and 4.66±1.08 mm (RCA). Correlations for LMCA and RCA diameters in 50 randomly chosen patients were 0.91 and 0.93 (interobserver) and 0.98 and 0.93 (intraobserver). Adjusted odds ratios for the relationship of LMCA and RCA diameters to calcium in male versus female patients were 5.65 (95% confidence interval [CI], 2.78-11.5) and 4.35 (95% CI, 2.24-8.47), respectively. Adjusted ratios and 95% CIs for the association of larger RCA diameter with age, hypertension, and body mass index were 1.36 (1.00-1.86), 3.13 (1.26-7.78), and 1.60 (1.16-2.22), respectively. Arterial diameters were larger in women and patients with higher calcium levels, and body mass index and hypertension were predictors of larger RCA diameters. These findings suggest a link between arterial remodeling and the severity of atherosclerosis.
authors.affiliation: Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, California 90502, USA. yasminshamshuddin@gmail.com
authors.forename: Yasmin S
authors.initials: YS
authors.lastname: Hamirani
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Emil
authors.initials: E
authors.lastname: Avanes
authors.forename: Jigar
authors.initials: J
authors.lastname: Kadakia
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D000368:Aged; D015992:Body Mass Index; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D015588:Observer Variation; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000453:epidemiology
keywords: Arteriosclerosis/complications/pathology; calcinosis/complications; coronary artery disease/etiology/pathology; coronary vessels/pathology/physiology; dilatation, pathologic/pathology; disease progression; models, cardiovascular; regression analysis; risk assessment; tomography, x-ray computed/methods
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