Calcium Score Derived from Coronary CT Angiography for Prediction of Complex Percutaneous Coronary Procedures.

Objectives- Calcium score is a useful metric derived from coronary CT angiography (CCTA) to assess the complexity of coronary artery disease (CAD). We aimed to determine whether Agaston score can reliably predict complex percutaneous coronary angiography (PCA).

Methods- Calcium scores were calculated on per-patient in 93 consecutive patients who underwent CCTA and subsequent coronary angiography. PCA complexity was defined by total fluoroscopy time, contrast volume, direct vs. balloon facilitated stenting, and the use of NC balloon post stenting.

Results- A total of 93 patients were allocated: 72% males, mean age 61.6 years, 48 interventional and 45 diagnostical. Patients were divided into two groups according to calcium score > or < than 400. In both the interventional and the diagnostic groups higher calcium score was associated with significantly higher mean contrast volume and fluoroscopy time: 97 vs. 76 ml, and 691 vs. 399 sec, p<0.01 in the interventional group, and 49 vs. 32 ml, and 385 vs. 196 sec, p<0.01 in the diagnostic group. Notably, stenting after balloon predilatation and NC balloon use post stenting were more prevalent with calcium score>400: 95% vs. 67% and 36% vs. 28%, p<0.01.

Conclusion- Calcium scores derived from CCTA correspond with complex PCI. Preprocedural preparation and intraprocedural management should be adjusted accordingly.