Author + information
- Wassim Mohammed Odeh,
- Zhen Qian,
- Parag Joshi,
- Kunal Bhatt,
- Reynaria Pitts,
- Viju Varghese,
- James Lee,
- Nancy Flockhart,
- Szilard Voros,
- Joseph Miller and
- Sarah Rinehart
Coronary calcified lesion's distribution and lesion-specific geometry better predict vessel stenosis and cardiac events than the total calcium score. Studies have shown renal insufficiency (RI) is associated with increased overall coronary artery calcium (CAC). However, how RI alters the distribution and geometry of calcified lesions remains unknown.
Prospectively, 80 intermediate risk patients (age: 63 ± 8; 96% male, FRS: 14% ± 4) underwent CAC scans. Agatston score (AS), lesion number, lesion distance to the ostia, and lesion length/width were measured using proprietary software. Lipoproteins, cystatin C, creatinine and eGFR were tested; One-way ANOVA was performed to compare lab values in patients with AS=0, 0-100, 100-400, and >400. Linear and multiple regressions were performed to assess their association with whole-heart and lesion-specific CAC. P<0.05 was significant.
eGFR significantly decreased in patients with higher AS (p=0.02) (Figure 1). Elevated Cystatin C and lower eGFR were significantly associated with riskier lesion characteristics, such as higher AS, more lesions, more distal lesion distribution, and larger size (Table 1), while creatinine was not. In multiple regression, eGFR was the only retained predictor of AS and lesion-specific measurements (Table 1).
Intermediate risk patients with RI have riskier lesion-specific characteristics, which may have implications for further risk stratification and therapeutic targets.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: CT/Multimodality I
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1140-334
- 2013 American College of Cardiology Foundation