Prevalence of Coronary Artery Calcification in Non-Contrast Non ECG-Gated Chest CT Scan of Patients With Significant Stenosis in Conventional Angiography in Comparison to Patients Without Significant Stenosis: A Cross-Sectional Study

Abstract

Background and Aims

Coronary artery disease is a main cause of mortality in developed and developing countries. Early diagnosis and treatment are important to reduce the burden of the disease. Correlation between coronary artery calcification in non-contrast non-ECG gated chest CT scan and conventional angiographic findings could be a helpful guide for risk assessment and the need for angiographic evaluation in patients with coronary artery calcification in non-contrast chest CT scan applied for other reasons.

Methods

A retrospective cross-sectional study was conducted in the cardiology department of Sina hospital and patients who underwent angiographic study between march 2020 and april 2021 with recent non-contrast non ECG-gated chest CT scan were selected. patients with coronary stent and history of CABG were excluded and angiographic findings, prevalence, diameter and pattern of coronary artery calcification in CT scan was studied in the selected patients.

Results

The prevalence of calcification in patients with significant stenosis was 94% and was significantly higher than patients without significant stenosis with prevalence of 46% (p-value < 0.001). Calcification length and area in patients with significant stenosis was 67.1 and 218.4 mm² and was significantly higher than patients without stenosis with length and area of 15.8 mm and 236.3 mm² (p-value < 0.001). there was meaningful correlation between length and area of calcification with maximum stenosis percentage seen in angiographic study (Pearson correlation: 0.61, 0.57).

Conclusion

The presence and extent of CAC on non-contrast, non-ECG-gated chest CT scans are correlated with significant coronary artery stenosis on angiography. These findings suggest that CAC assessment on routine chest CT scans can be used as a criterion for risk stratification and determining the need for angiographic evaluation to rule out significant stenosis.