Lozoya RJJ, Vallejo VE, Murguía AA, Soto ME

Language: Spanish
References: 11
Page: 172-176
PDF size: 264.28 Kb.

ABSTRACT

Introduction: the coronary calcium score is a method with prognostic value added to cardiac single-photon emission computed tomography to predict cardiovascular events and has been shown to be superior to traditional risk factors. Objective: evaluate in asymptomatic patients the coronary calcium score cut-off point for myocardial ischemia measured by single-photon emission computed tomography and its value as a predictor of ischemia severity, as well as to see its relation with cardiovascular risk factors and arterial location. Material and methods: retrospective design from November 2012 to June 2018. Asymptomatic patients, both genders, age 63 ± 11 who underwent coronary calcium score by computed tomography and cardiac single-photon emission computed tomography with a range of difference between them of one year. Results: 181 patients aged 63 ± 11 were included. The coronary calcium score in patients with and without ischemia was 411 and 92 respectively p = (0.0001). The area under the curve for ischemia was 253 AU in the Coronary Calcium Score. The determining factors of ischemia were diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, smoking and Coronary Calcium Score > 300 Agatston Units. Conclusion: the Coronary Calcium Score is useful to evaluate cardiac ischemia a value greater than 300 AU is the best predictor of ischemia however the Coronary Calcium Score of 253 Agatston Units can be an indicator and predictor of ischemia in asymptomatic subjects.

REFERENCES

1. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation. 2015; 131 (4): e29-322.

2. Greenland P, Blaha MJ, Budoff MJ, Erbel R, Watson KE et al. Coronary calcium score and cardiovascular risk. J Am Coll Cardiol. 2018; 72 (4): 434-447.

3. Blaha MJ, Mortensen MB, Kianoush S, Tota-Maharaj R, Cainzos-Achirica M et al. Coronary artery calcium scoring. Is it time for a change in methodology? J Am Coll Cardiol Img. 2017; 10: 923-937.

4. Hecht H, Blaha MJ, Berman DS, Nasir K, Budoff M, Leipsic J et al. Clinical indications for coronary artery calcium scoring in asymptomatic patients: expert consensus statement from the society of cardiovascular computed tomography. J Cardiovasc Comput Tomogr. 2017; 11 (12): 157-168.

5. Rumberger JA, Simons DB, Fitzpaterick LA, Sheedy PF, Schwartz RS et al. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area: a histopathologic correlative study. Circulation. 1995; 92 (8): 2157-2162.

6. Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J et al. Exercise myocardial perfusion SPECT in patients without known coronary artery disease: incremental prognostic value and use in risk stratification. Circulation. 1996; 93 (5): 905-914.

7. Engbers EM, Timmer JR, Ottervanger JP, Mouden M, Knollema S, Jager P et al. Prognostic value of coronary artery calcium scoring in addition to single-photon emission computed tomographic myocardial perfusion imaging in symptomatic patients. Circ Cardiovasc Imaging. 2016; 9 (5): e003966.

8. Kim YJ, Hur J, Lee HJ, Chang H, Nam J, Hong Y et al. Meaning of zero coronary calcium score in symptomatic patients referred for coronary angiography. Eur Heart J Cardiovasc Imaging. 2012; 13 (9): 776-785.

9. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano A et al. European Guidelines on cardiovascular disease prevention in clinical practice. The sixth joint task force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts). Eur Heart J. 2016; 37 (29): 2315-2381.

10. Greenland P, Bonow RO. How low-risk is a coronary calcium score of zero? The importance of conditional probability. Circulation. 2008; 117: 1627-1629.

11. Puchner SB, Mayrhofer T, Park J, Lu MT, Liu T, Maurovich-Horvat P et al. Differences in the association of total versus local coronary artery calcium with acute coronary syndrome and culprit lesions in patients with acute chest pain: the coronary calcium paradox. Atherosclerosis. 2018; 274: 251-257. doi: 10.1016/j.atherosclerosis.2018.04.017.

EVIDENCE LEVEL

III