Abstract
Background: The value of assessing coronary artery calcium (CAC) with regard to characterizing unstable coronary artery disease remains controversial.
Purpose: To evaluate the amount of CAC in patients with an acute marker-positive coronary syndrome in segments containing the culprit lesion compared with the remote coronary segments.
Material and Methods: Thirty-two patients with a marker-positive acute coronary syndrome were examined using electron-beam computed tomography (EBCT), selective coronary angiography and, in some, intravascular ultrasound. The coronary anatomy was analyzed according to the segmental classification proposed by the American Heart Association (AHA).
Results: The total EBCT coronary artery calcium score (CAC, Agatston method) was 251±371 (range 0–1629). In 81% of the patients, a greater CAC score was observed than expected on the basis of age and gender. In 30 patients, significant stenoses were detected. The CAC score of the culprit vessel was 108±163 vs 78±134 in the non-culprit vessels and did not differ significantly (P=0.4). The mean CAC score of the coronary segment (AHA classification) containing the culprit lesion was 51±82 vs 29±45 in the other coronary artery segments (P=0.14). Of the two patients with no CAC detected by EBCT, one had no coronary atherosclerosis (confirmed by intravascular ultrasound) and one had one vessel coronary artery disease.
Conclusion: Coronary calcium related to the culprit lesion in patients with a marker-positive acute coronary syndrome showed a tendency for an increased amount but was not statistically different from the amount of coronary calcium in remote vessel segments.
Key words::
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.