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Published online before print December 26, 2002, 10.1148/radiol.2262011903
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(Radiology 2003;226:483-488.)
© RSNA, 2003

Cardiac Imaging

Coronary Calcification Compared in Patients with Acute versus in Those with Chronic Coronary Events by Using Dual-Sector Spiral CT1

Joseph Shemesh, MD, Sara Apter, MD, Yacov Itzchak, MD and Michael Motro, MD

1 From the Cardiac Rehabilitation Institute (J.S., M.M.) and Department of Diagnostic Imaging (S.A., Y.I.), Chaim Sheba Medical Center, Sackler Faculty of Medicine, Tel-Hashomer, 52621, Israel. From the 2001 RSNA scientific assembly. Received November 27, 2001; revision requested January 4, 2002; final revision received June 7; accepted July 3. Address correspondence to J.S. (e-mail: dshemesh@netvision.net.il).

PURPOSE: To compare underlying calcific atherosclerotic lesions in acute versus chronic coronary events in patients with hypertension by using dual-sector spiral computed tomography (CT).

MATERIALS AND METHODS: Eight hundred eighty-four calcific lesions were analyzed in a cohort of 50 patients (39 men, 11 women; age range, 55–79 years; mean age, 66 years ± 6 [SD]) with hypertension who sustained a coronary event during 3-year follow-up. All underwent dual-sector spiral CT within 12 months before the event. Twenty-nine patients had an acute event (acute group): acute myocardial infarction, 20; unstable angina pectoris, six; acute ischemia, two; sudden death, one. Twenty-one patients had chronic manifestations of obstructive coronary disease (chronic group): severe stable angina, five; angiographically identified disease, 12; disease requiring angioplasty, two; and disease requiring bypass surgery, two. To examine differences between the two study groups, the {chi}2 or Fisher exact test was applied to categorical parameters and the two-sample t test or Wilcoxon rank sum test to quantitative parameters.

RESULTS: High prevalence of coronary calcium (total coronary calcium score [TCS] >0) was observed in both groups: 93% (27 of 29) in the acute and 95% (20 of 21) in the chronic group. There were 518 lesions in the chronic and 366 in the acute group, with a median number of 35 and nine lesions per patient, respectively (P < .001). The median TCS was 906 for the chronic and 63 for the acute group (P < .01).

CONCLUSION: A mild degree of calcification characterizes patients with acute coronary events, while diffuse high-attenuation calcific plaques are associated with chronic coronary events.

© RSNA, 2003

Index terms: Coronary vessels, calcification, 54.812 • Coronary vessels, CT, 54.12115 • Coronary vessels, diseases, 54.76 • Heart, diseases, 518.76




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