Coronary Artery Calcification Can Predict Acute Coronary Syndrome

Coronary artery calcification (CAC) is a significant predictor of acute coronary syndrome (ACS), particularly among certain groups of patients, according to a study published in the American Journal of Roentgenology.

Researchers from Massachusetts General Hospital and Harvard Medical School sought to evaluate the frequency of unreported CAC and its association with a diagnosis of ACS. To do this, they obtained data from 469 patients who underwent emergency pulmonary CT angiography for suspected pulmonary thromboembolism.

Positive findings for CAC were recorded, all pulmonary CT angiograms were reevaluated by a radiologist and findings of CAC were recorded.

The findings showed that approximately 11.1 percent of the patients who underwent the pulmonary CT angiograms did have a pulmonary thromboembolism and 43.8 percent had CAC. “The incidence of CAC was significantly higher in patients with an ACS diagnosis than without ACS (56.2 percent versus 40.4 percent, respectively),” wrote the authors.

Men who were 45 years old or younger and women 55 years old or younger had a positive association between CAC and ACS, as did those without cardiometabolic factors.

Ninety-eight of the patients (45 percent) had positive CAC, but it had not been reported. ACS was diagnosed in 31.6 percent of patients among whom CAC had not been reported. “There was a significant association between CAC and ACS in patients with unreported CAC,” the researchers noted, with the association being more prominent in the subgroups described.

The researchers concluded that although CAC is often not reported in pulmonary CT angiography studies, it “is a significant predictor of ACS particularly in younger patients, patients without pulmonary thromboembolism, and those without cardiometabolic risk factors.” They recommend that radiologists should assess CAC findings, especially in these subgroups.