The ratio of the max-to-mean coronary artery calcium score in the most calcified vessel is associated with the presence of coronary artery disease. Issue 147 (February 2022)

• Record Type: Journal Article
• Authors: Chen, Wenya; Li, Hongwei; Lu, Zhijiao; Guo, Qi; Liu, Xiao; Sun, Runlu; Zhang, Jie; Huang, Jingjing; Chen, Qian; Wang, Junjie; Shen, Jun; Zhang, Yuling
• Is Part Of: European journal of radiology. Issue 147(2022)
• Publication Date: 2022-02
• Subjects: Coronary artery calcium score -- Agatston score -- Volumetric score -- Mass score -- Coronary computed tomographic angiology -- Coronary artery disease; Agatston scoremax:mean ratio of the max-to-mean Agatston score in the most calcified vessel -- AUC area under the curve -- CAD coronary artery disease -- CACS coronary artery calcium score -- CACSmax:mean ratio of the max-to-mean CACS in the most calcified vessel -- CI confidence interval -- CTA computed tomography angiography -- ICA invasive coronary angiography -- LASSO least absolute shrinkage and selection operator -- Mass scoremax:mean ratio of the max-to-mean mass score in the most calcified vessel -- OR odds ratio -- ROC receiver operating characteristic -- Volumetric scoremax:mean ratio of the max-to-mean volumetric score in the most calcified vessel; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2021.110134
• Languages: English
• ISSNs: 0720-048X

Abstract

Graphical abstract: Highlights: We proposed a novel quantitative parameter called the ratio of max-to-mean CACS in the most calcified vessel (CACSmax: mean ), calculated by the CACS in the most calcified vessel/the average CACS of calcified vessels. The CACSmax: mean is positively associated with the presence of coronary artery disease (CAD). The CACSmax: mean of Agatston score, not that of volumetric scoremax: mean or mass scoremax: mean, was remained to be necessary covariates in the least absolute shrinkage and selection operator (LASSO) analysis. Abstract: Purpose: This study aimed to clarify the relationship between the severity of the calcium burden in the most calcified coronary vessel and coronary artery disease (CAD). Method: Of 2150 patients, 376 examined by both coronary computed tomographic angiography and invasive coronary angiography (ICA) within 30 days at Sun Yat-sen Memorial Hospital between March 2011 and July 2020 were included. Three coronary artery calcium scores (CACSs), including the Agatston score, volume score, and mass score, and other clinical variables were recorded. The ratio of max-to-mean CACS in the most calcified vessel (CACSmax:mean ) was defined as the CACS in the most calcified vessel/average CACS of the four major epicardial coronary arteries. Logistic regression and least absolute shrinkage and selection operator (LASSO) analyses were performed to assess the relationship between CACSmax:mean and CAD. Results: CACSmax:mean was higher in 81.1% of subjects diagnosed with CAD than in subjects without CAD. In multivariate logistic regression analysis, CACSmax:mean determined by the Agatston score, volumetric score, and mass score was associated with CAD. In LASSO analysis, Agatston scoremax:mean (not the total Agatston score or other CACSmax:mean ) had the strongest correlation with CAD (β = 0.125). AUCs in the training set and the validation set were 0.811 and 0.789, respectively. Increased age, diabetes and hypertension correlated with higher Agatston scoremax:mean . Conclusions: In addition to total CACS, CACSmax:mean may be a novel diagnostic parameter for CAD, showing the calcium burden severity.