Is coronary calcium scoring too late? Total body arterial calcium burden in patients without known CAD and normal MPI
- Al Azhar University (Egypt)
- Saint Luke’s Mid America Heart Institute (United States)
- Renown Institute for Heart and Vascular Health (United States)
- Newport Diagnostic Center (United States)
- South Coast Radiological Medical Group (United States)
- National Museum of Natural History Smithsonian Institution (United States)
- Irvine School of Medicine, University of California (United States)
- University of Southern California, Leonard Davis School of Gerontology and Dornsife College (United States)
- Icahn School of Medicine at Mount Sinai (United States)
- Long Beach Memorial (United States)
- Ascension Healthcare (United States)
Background: Patients with normal myocardial perfusion imaging (MPI) have a good prognosis. However, pre-clinical coronary and extracoronary atherosclerosis may exist in the absence of myocardial ischemia. Methods: 154 Egyptian patients (mean age 53 years) underwent whole-body non-contrast CT following normal MPI. Results: Atherosclerosis in the form of calcification was observed in ≥1 vascular bed in 115 of 154 (75%) patients. This included the iliofemoral (62%), abdominal aorta (53%), thoracic aorta (47%), coronary (47%), and carotid (25%) vascular beds. Mean total body calcium score was 3172 ± 530 AU. Extracoronary atherosclerosis in patients with a zero coronary artery calcium (CAC) score was common, occurring in the above-listed beds 42%, 36%, 29%, and 7% of the time, respectively. CAC was rarely present without iliofemoral or abdominal aortic calcification. Conclusion: Quantitative assessment of calcification in different vascular beds demonstrates that extracoronary atherosclerosis is common in patients who have normal MPI. Atherosclerotic calcifications are most common in the iliofemoral arteries and abdominal aorta, which typically predate coronary calcifications. An imaging strategy to detect extracoronary atherosclerosis could lead to greater understanding of the natural history of atherosclerosis in its long pre-clinical phase and possibly to earlier preventive strategies.
- OSTI ID:
- 22962203
- Journal Information:
- Journal of Nuclear Cardiology (Online), Journal Name: Journal of Nuclear Cardiology (Online) Journal Issue: 6 Vol. 25; ISSN 1532-6551
- Country of Publication:
- United States
- Language:
- English
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