Extensive Thoracic Aortic Calcification is an Independent Predictor of Coronary Artery Calcium Conversion among Asymptomatic Individuals with Coronary Calcium Score of Zero

Yafim Brodov Heidi Gransar Alan Rozanski Sean Hayes John Friedman Louise Thomson Damini Dey James Min Leslee Shaw PK Shah Guido Germano Daniel Berman
Nuclear Cardiology and Cardiac Imaging, Cedars Sinai Medical Center, Los Angeles, California, USA

Objectives: The predictive value of thoracic aortic calcium (TAC) scores for coronary artery

calcium (CAC) conversion (CAC>0) has not been fully evaluated.

Methods: We studied 1648 asymptomatic subjects (mean age 52±9 years, 54% male) with

baseline CAC=0 who underwent repeat CAC scanning 5 years later (range 3-14 years). TAC was

assessed in the ascending and descending aorta. CAC and TAC were measured using Agatston

scores. The cohort was categorized by baseline TAC scores: TAC=0 (n=1381 subjects), TAC 1-9

(n=54), TAC 10-99 (n=132) and TAC≥100 (n=81). Logistic regression was used to examine the

predictive value of baseline TAC scores for CAC>0 on repeat scans.

Results: On repeat scanning, 380 subjects (23%) developed CAC>0. The frequency of CAC>0

increased progressively across baseline TAC (TAC=0, TAC 1-9, TAC 10-99 and TAC≥100)

22%, 26%, 26% and 37%, respectively (P for trend =0.0025). Univariate analysis showed

baseline TAC ≥100 was a significant predictor of CAC>0 in repeat scans, while either TAC 1-

9 or TAC 10-99 were not, OR 2.10 [CI 1.32-3.36], P=0.002; OR 1.25 [CI 0.67-2.33], P=0.5; OR

1.24 [CI 0.82-1.87], P=0.3, respectively. In multivariable analysis, TAC ≥100 OR 1.90 [CI 1.08-

3.33], P=0.026, was a significant predictor of CAC>0, along with age, male gender, diabetes,

hypertension, hypercholesterolemia and time between scans.

Conclusions: The likelihood of conversion to CAC>0 increases with increasing TAC scores.

TAC ≥100 is an independent predictor of CAC conversion. Subjects with CAC=0 and extensive

TAC (TAC ≥100) may merit earlier repeat scanning than those with no TAC or lower TAC

scores.









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