title: CT-based abdominal aortic calcification score as a surrogate marker for predicting the presence of asymptomatic coronary artery disease.
abstract: OBJECTIVE
  To assess the value of a CT-based abdominal aortic calcification (AAC) score as a surrogate marker for the presence of asymptomatic coronary artery disease (CAD).
  
  
  METHODS
  The AAC scores of 373 patients without cardiac symptoms who underwent both screening coronary CT angiography and abdominal CT within one year were calculated according to the Agatston method. Logistic regression was used to derive two multivariate models from traditional cardiovascular risk factors, with and without AAC scores, to predict the presence of CAD. The AAC score and the two multivariate models were compared by calculating the area under the receiver operating characteristic curve (AUC) and the net reclassification improvement (NRI).
  
  
  RESULTS
  The AAC score alone showed a marginally higher AUC (0.823 vs. 0.767, P = 0.061) and significantly better risk classification (NRI = 0.158, P = 0.048) than the multivariate model without AAC. The multivariate model using traditional factors and AAC did not show a significantly higher AUC (0.832 vs. 0.823, P = 0.616) or NRI (0.073, P = 0.13) than the AAC score alone. The optimal cutoff value of the AAC score for predicting CAD was 1025.8 (sensitivity, 79.5 %; specificity, 75.9 %).
  
  
  CONCLUSIONS
  AAC scores may serve as a surrogate marker for the presence or absence of asymptomatic CAD.
  
  
  CONCLUSIONS
  • Severe vascular calcification indicates a high probability of coronary artery disease. • Vascular calcification in the abdominal aorta can be quantified by computed tomography. • Abdominal CT could lead to early detection of asymptomatic coronary artery disease.
authors.affiliation: Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 120-752, Korea.
authors.forename: Chansik
authors.initials: C
authors.lastname: An
authors.forename: Hye-Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Ahn
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Yong Eun
authors.initials: YE
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D061205:Vascular Calcification / Q000150:complications / Q000000981:diagnostic imaging*