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Dudink EAMP, Peeters FECM, Altintas S, et al. Agatston score of the descending aorta is independently associated with coronary events in a low-risk population. Open Heart. 2018;5(2):e000893doi: 10.1136/openhrt-2018-000893.
Dudink, E. A. M. P., Peeters, F. E. C. M., Altintas, S., Heckman, L. I. B., Haest, R. J., Kragten, H., Kietselaer, B. L. J. H., Wildberger, J., Luermans, J. G. L. M., Weijs, B., & Crijns, H. J. G. M. (2018). Agatston score of the descending aorta is independently associated with coronary events in a low-risk population. Open heart, 5(2), e000893. https://doi.org/10.1136/openhrt-2018-000893
Dudink, Elton A M P, et al. "Agatston score of the descending aorta is independently associated with coronary events in a low-risk population." Open heart vol. 5,2 (2018): e000893. doi: https://doi.org/10.1136/openhrt-2018-000893
Dudink EAMP, Peeters FECM, Altintas S, Heckman LIB, Haest RJ, Kragten H, Kietselaer BLJH, Wildberger J, Luermans JGLM, Weijs B, Crijns HJGM. Agatston score of the descending aorta is independently associated with coronary events in a low-risk population. Open Heart. 2018 Nov 24;5(2):e000893. doi: 10.1136/openhrt-2018-000893. eCollection 2018. PMID: 30564374; PMCID: PMC6269642.
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Open Heart. 2018 Nov 24;5(2):e000893. doi: 10.1136/openhrt-2018-000893. eCollection 2018.

Agatston score of the descending aorta is independently associated with coronary events in a low-risk population.

Open heart

Elton A M P Dudink, Frederique E C M Peeters, Sibel Altintas, Luuk I B Heckman, Rutger J Haest, Hans Kragten, Bas L J H Kietselaer, Joachim Wildberger, Justin G L M Luermans, Bob Weijs, Harry J G M Crijns

Affiliations

  1. Department of Cardiology, Maastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.
  2. Department of Cardiology, St. Anna Hospital, Geldrop, The Netherlands.
  3. Department of Cardiology, Zuyderland Medical Center, Heerlen, The Netherlands.
  4. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.

PMID: 30564374 PMCID: PMC6269642 DOI: 10.1136/openhrt-2018-000893

Abstract

OBJECTIVES: A standard coronary artery calcium scan includes part of the aorta. This additional information is often not included in routine analyses. We aimed to determine the feasibility of assessing the Agatston score of the descending aorta calcification (DAC) on standard coronary calcium scans and the association of this score with coronary events in a low-risk study population.

METHODS: Between January 2008 and March 2011, 390 consecutive patients who were referred for cardiac CT as part of work-up for pulmonary vein isolation (n=115) or assessment of presence of coronary artery disease (n=275) were included. At baseline, all patients were free of a history of cardiovascular disease. Two independent observers determined the Agatston score of the ascending aorta and descending aorta.

RESULTS: A total of 16 patients (4.1%) developed coronary events (acute coronary syndrome (n=6) and symptomatic significant coronary artery disease requiring treatment (n=10)) during a follow-up of 67±12 months, with more events in patients with calcifications in the descending aorta than in those without (8.4% vs 3.7 %; p=0.08). Multivariable Cox regression, corrected for Framingham Risk Score (FRS) and coronary Agatston score (CAC), revealed that DAC was independently associated with coronary events (per 100 units; HR: 1.06, 95% CI 1.02 to 1.09; p=0.001). DAC furthermore increased the identification of patients that will experience a coronary event (area under the curve: 0.68 for FRS only, 0.75 for FRS+CAC and 0.78 for FRS+CAC+DAC).

CONCLUSIONS: The Agatston score of the descending aorta could be included in the standard analysis of cardiac CT scans of low-risk patients since it holds valuable information for the prediction of coronary events.

Keywords: X-ray computed; aorta; calcification; coronary artery disease; follow-up studies; physiologic; tomography

Conflict of interest statement

Competing interests: One author (JW) of this manuscript declares institutional relationships with the following companies: Siemens AG, Bayer Healthcare, Philips, GE, all outside submitted work.

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