title: Aortic arch calcification is strongly associated with coronary artery calcification.
abstract: BACKGROUND
  We aimed to investigate the association between aortic arch and coronary artery calcification (CAC). We postulated that low- and high-risk CAC scores could be predicted with the evaluation of standard chest radiography for aortic arch calcification (AAC).
  
  
  METHODS
  Consecutive patients who were referred for a multidetector computerized tomography (MDCT) examination were enrolled prospectively. All patients were scanned using a commercially available 64-slice MDCT scanner for the evaluation of CAC score. A four-point grading scale (0, 1, 2 and 3) was used to evaluate AAC on the standard posterior-anterior chest radiography images.
  
  
  RESULTS
  The study group consisted of 248 patients. Median age of the study group was 52 (IQR: 10) years, and 165 (67 %) were male. AAC grades (r = 0.676, p < 0.0001) and age (r = 0.518, p < 0.0001) were significantly and positively correlated with CAC score. Presence of AAC was independently associated with the presence of CAC (OR: 11.20, 95 % CI 4.25 to 29.52). An AAC grade of ≥ 2 was the strongest independent predictor of a high-risk CAC score (OR: 27.42, 95 % CI 6.09 to 123.52). Receiver operating characteristics curve analysis yielded a strong predictive ability of AAC grades for a CAC score of ≥ 100 (AUC = 0.892, P < 0.0001), and ≥ 400 (AUC = 0.894, P < 0.0001). Absence of AAC had a sensitivity, specificity and accuracy of 90 %, 84 % and 89 %, respectively, for a CAC score of < 100. An AAC grade of ≥ 2 predicted a CAC score of ≥ 400 with a sensitivity, specificity and accuracy of 68 %, 98 % and 95 %, respectively.
  
  
  CONCLUSIONS
  AAC is a strong and independent predictor of CAC. The discriminative performance of AAC is high in detecting patients with low- and high-risk CAC scores.
authors.affiliation: Karabuk University Hospital, Department of Cardiology, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Adar
authors.affiliation: Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Erkan
authors.affiliation: Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gokdeniz
authors.affiliation: Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Karadeniz
authors.affiliation: Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Radiology, Turkey.
authors.forename: Ismail G
authors.initials: IG
authors.lastname: Cavusoglu
authors.affiliation: Karabuk University Hospital, Department of Cardiology, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Onalan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D001027:Aortography / Q000379:methods*; D019540:Area Under Curve; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Aortic arch calcification; chest radiography; computed tomography; coronary artery calcification