Agatston Calcium Score as a Predictor of Obstructive Coronary Artery Disease: A Cross-Sectional CCTA-Based Study

Abstract

Background: Agatston calculated coronary artery calcium scoring (CAC) has been firmly in place as a means of finding and measuring the burden of calcified atherosclerosis. Although zero calcium score is typically indicative of a reduced possibility of major coronary artery disease (CAD), it is less efficient in ruling out the occurrence of obstruction lesions. It has been demonstrated that calcium score has a robust association with the degree and severity of coronary stenosis on CT angiography (CCTA).

Objectives: To assess the usefulness of the Agatston calcium score in ruling out or ruling in clinically significant stenosis (of the coronary arteries) (>50%) in symptomatic individuals.

Methodology: The investigations of 183 patients referred to receive CCTA at the Iraqi Center of Heart Disease are carried out in the form of a cross-sectional study. Patients are grouped by calcium score (0, 100, 200 99, 100, 200 or greater), age bracket and extent of coronary stenosis. There are standardized preparations and CCTA protocols used with calcium scoring done through non contrasted CT.

Results: Within patients with zero CAC, zero stenosis was located in 78.5 percent of patients, non-significant stenosis in 15.4 percent of patients and significant stenosis in 6.1 percent of patients. Among the patients with CAC 100 or more, 75 percent of them presented with significant stenosis. There is a significant positive correlation between the rise of calcium score and severity of stenosis (P=0.001). There is also a relation between older age, calcium scores and stenosis rates (P=0.01 and P=0.02 respectively). Significant stenosis is more often found in male patients compared to female ones (P=0.02).

Conclusion: Agatston calcium score is also a good indicator of coronary artery stenosis. Calcium scores above 100 are very strong indicators of a good CCTA, whereas zero scores lower risks of CAD seriousness, but do not extinguish it.

Keywords: Calcium score, coronary artery disease, CT angiography, Agatston score, coronary stenosis.