Author + information
- Hyeon Ju Jeong,
- Hyung-Bok Park,
- Hyun-Jin Kim,
- Yong-Sung Seo,
- Yoon-Hyeong Cho,
- Tae-Young Choi,
- Eui-Seock Hwang and
- Deok-Kyu Cho
Background: Coronary artery calcium (CAC) score generally correlates well with obstructive coronary artery disease (CAD). However, in some cases, obstructive CAD has been detected in patients with zero or very low (<10) calcium scores. On top of that, smoking is one of the strongest risk factors for CAD. We, therefore, evaluated how smoking in extremely low CAC score patients has an impact on the detection of obstructive CAD.
Methods: In this study, 1094 asymptomatic patients without previous history of CAD underwent calcium scans and coronary computed tomography angiographies (CTA) were consecutively enrolled. Among those patients, 271 patients with zero or very low (<10) calcium scores were analyzed coronary artery stenosis by CTA. The very low CAC score group was defined by having a less than 10 CAC score and severe stenosis was defined by more than 70% stenosis being found in any of the major coronary arteries. Age, gender (male), hypertension (HTN), Type II diabetes (DM), dyslipidemia, and smoking status were evaluated as predictors for severe CAD.
Results: Among the 271 patients, 12.5% (n=34) showed severe stenosis (≥70%), 46.8% (n=127) were male and the mean age was 61.6 ± 10.9. The mean Calcium score was 7.8 ± 10.6 and zero calcium score was 50.9% (n=138). There was no significant difference between the obstructive CAD group and the no or non-obstructive CAD group with regards to age, gender, BMI, HTN, DM, CKD and dyslipidemia. The percentage for patients who smoked was significantly higher in the severe stenosis CAD group when compared with the control group (65% vs. 15%, p=0.017). This revealed that the most significant predictor for severe CAD was current smoking (OR: 2.30, 95%CI 1.03-5.11, p=0.041) in multivariable analysis.
Conclusions: Our analysis demonstrated that smoking showed significant correlation with severe CAD even in zero or extremely low CAC score asymptomatic patients. Among those patients, a CAC scan alone might not be enough for CAD screening.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: Coronary Calcium Scoring and CV Risk Assessment
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1198-235
- 2017 American College of Cardiology Foundation