Coronary artery calcium score in patients with non-ST-segment elevation acute coronary syndrome

Q4 Medicine

REC: CardioClinics Pub Date : 2025-07-01 DOI:10.1016/j.rccl.2025.02.002

Samuel Del Castillo García, Ignacio Iglesias Gárriz, Carmen Garrote Coloma, Javier Vara Manso, José Félix Corral Fernández, David Alonso Rodríguez, Felipe Fernández Vázquez

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Abstract

Introduction and objectives

Coronary artery calcium (CAC) score is a marker of coronary atherosclerotic burden and can provide diagnostic and prognostic information in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). This study aims to evaluate the relationship between CAC and the need for revascularization in patients with NSTEACS.

Methods

We included prospectively 276 patients aged ≥ 18 years admitted with NSTEACS. A computed tomography was performed to measure CAC, categorized into groups: 0 Agatston units (AU), 1–100 AU, 101–400 AU, and > 400 AU. All patients underwent invasive coronary angiography.

Results

The median CAC score was 221 AU. A total of 62.7% of patients underwent revascularization; the proportion of revascularization increased with CAC, with 25% in the CAC = 0 group and 83.3% in the high CAC (> 400 AU) group. The CAC score demonstrated a negative predictive value of 69.4% for ruling out significant stenosis.

Conclusions

The CAC score is significantly associated with the need for revascularization in patients with NSTEACS, highlighting the atherosclerotic burden and its potential in risk stratification and clinical decision-making.

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非st段抬高急性冠状动脉综合征患者冠状动脉钙评分

简介和目的冠状动脉钙（CAC）评分是冠状动脉粥样硬化负荷的标志，可以为非st段抬高急性冠状动脉综合征（NSTEACS）患者提供诊断和预后信息。本研究旨在评估非steacs患者CAC与血运重建需求之间的关系。方法前瞻性纳入276例年龄≥18岁的NSTEACS患者。计算机断层扫描测量CAC，分为：0 Agatston单位（AU）、1-100 AU、101-400 AU和>；400个AU。所有患者均行有创冠状动脉造影。结果CAC评分中位数为221 AU。62.7%的患者接受了血管重建术；血运重建比例随CAC升高而增加，CAC = 0组为25%，高CAC组为83.3% (>；400 AU)组。CAC评分对排除明显狭窄的阴性预测值为69.4%。结论CAC评分与非steacs患者的血运重建需求显著相关，突出了动脉粥样硬化负担及其在风险分层和临床决策中的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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