Discrepancies between Coronary Artery Calcium Score and Coronary Artery Disease Severity in Computed Tomography Angiography Studies

Autor: Paweł Gać, Arkadiusz Jaworski, Agnieszka Parfianowicz, Jakub Karwacki, Andrzej Wysocki, Rafał Poręba
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Diagnostics, Vol 14, Iss 17, p 1928 (2024)
Druh dokumentu: article
ISSN: 2075-4418
DOI: 10.3390/diagnostics14171928
Popis: The aim of this paper is to demonstrate the difference in usefulness of the coronary artery calcium score (CACS) and the full assessment of the severity of coronary artery disease in coronary computed tomography angiography (CCTA) studies. The difference between the population risk of coronary artery disease (CAD) assessed by the CACS and the severity of CAD was demonstrated in images from two CCTA studies. The first image is from a patient with a CACS of 0 and significant coronary artery stenosis. In the native phase of CCTA examination, no calcified changes were detected in the topography of the coronary arteries. In the middle section of the left descending artery (LAD), at the level of the second diagonal branch (Dg2), a large non-calcified atherosclerotic plaque was visible. Mid-LAD stenosis was estimated to be approximately 70%. The second image features a patient with a high CACS but no significant coronary artery stenosis. The calcium score of individual coronary arteries calculated using the Agatston method was as follows: left main (LM) 0, LAD 403, left circumflex (LCx) 207.7, right coronary artery (RCA) 12. CACS was 622.7, representing a significant population risk of significant CAD. In the proximal and middle sections of the LAD, numerous calcified and mixed atherosclerotic plaques with positive remodeling were visible, causing stenosis of 25–50%. Similarly, in the proximal and middle sections of the LCx, numerous calcified and mixed atherosclerotic plaques with positive remodeling were visualized, causing stenoses of 25–50%. Calcified atherosclerotic plaques were found in the RCA, causing stenosis
Databáze: Directory of Open Access Journals
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