The predictive value of computed tomography calcium scores: a comparison with quantitative volumetric intravascular ultrasound

Okabe, Teruo; Mintz, Gary S.; Weigold, Wm. Guy; Roswell, Robert; Joshi, Subodh; Lee, Sung Yun; Lee, Bongryeol; Steinberg, Daniel H.; Roy, Probal; Pinto Slottow, Tina L.; Kaneshige, Kimberly; Torguson, Rebecca; Xue, Zhenyi; Satler, Lowell F.; Kent, Kenneth M.; Pichard, Augusto D.; Weissman, Neil J.; Lindsay, Joseph; Waksman, Ron

doi:10.1016/j.carrev.2008.07.001

« Previous Next »Cardiovascular Revascularization Medicine
Volume 10, Issue 1 , Pages 30-35, January 2009

The predictive value of computed tomography calcium scores: a comparison with quantitative volumetric intravascular ultrasound

Teruo Okabe
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Gary S. Mintz
- Cardiovascular Research Foundation, Washington, DC, USA
Wm. Guy Weigold
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Robert Roswell
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Subodh Joshi
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Sung Yun Lee
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Bongryeol Lee
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Daniel H. Steinberg
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Probal Roy
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Tina L. Pinto Slottow
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Kimberly Kaneshige
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Rebecca Torguson
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Zhenyi Xue
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Lowell F. Satler
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Kenneth M. Kent
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Augusto D. Pichard
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Neil J. Weissman
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Joseph Lindsay
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
Ron Waksman
- Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA
- Corresponding author. Washington Hospital Center, 110 Irving St. NW, Suite 4B-1, Washington, DC 20010, USA. Tel.: +1 202 877 2812; fax: +1 202 877 2715.

Received 17 July 2008; accepted 17 July 2008.

Abstract

Objective

To evaluate the relationship between coronary artery calcium scoring (CACS) and intravascular ultrasound (IVUS) calcification and disease severity.

Methods

Forty-five angina patients who underwent CACS 18±23 days before IVUS were studied. The CACS was recorded for each lesion matched to a specific IVUS lesion. Cross-sectional area measurements of the external elastic membrane, lumen area, plaque and media, and plaque burden were performed. The arc and length of calcification were measured.

Results

There were 106 calcified lesions detected by IVUS. Eighty-five of those lesions (80%) were detected by CACS, but 21 calcified lesions (20%) were missed. Fourteen (50%) out of 28 of the lesions with an IVUS-calcium arc below the 25th percentile (51.4°) were detected by CACS vs. 91% of lesions with an IVUS-calcium arc >51.4° (P<.05). Similarly, 21 (58%) of 36 lesions ≤3 mm in length were detected vs. 91% of lesions >3 mm (P<.05). We divided IVUS-calcified lesions into CACS ≤10 and >10. Mean plaque burden, calcified length, and arc of calcium increased significantly, while minimum lumen area decreased with increasing CACS. There was the same tendency in culprit and nonculprit calcified lesions, respectively. Multivariate analysis showed a calcified length (regression coefficient=8.718, 95% CI 4.668–12.77, P<.001) and an arc of calcium (regression coefficient=2.789, 95% CI 1.419–4.119, P<.001) were significant predictors for CACS.