Clin Res Cardiol 100, Suppl 1, April 2011

P1347 - Progression of Coronary Calcifications: A Prospective Study in 1075 Patients Over 5 Years
 
M. Greif1, F. von Ziegler1, J. Rümmler1, C. Becker2, K. Nikolaou2, A. Knez3, A. Leber4, A. Becker1
 
1Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Campus Großhadern, München; 2Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, München; 3Innere Medizin, Krankenhaus Weilheim, Weilheim; 4Klinik für Kardiologie u. Internistische Intensivmedizin, Städt. Klinikum München GmbH, Herzzentrum München-Bogenhausen, München;
 
Background: Coronary calcifications are a well established marker of coronary atherosclerosis and a valuable tool for cardiovascular risk stratification. Still little is known about the natural progression of coronary calcifications. We therefore determined changes in coronary calcium scores in this prospective study over 5 years.
Methods: We examined 1075 patients, 679 men, 396 women, age 53 ± 17 years, who were eligible for repeated CT scans of the chest due to staging examinations. In all patients coronary artery disease was not known at study entry. Images were obtained using a 64 slice scanner (Somatom 64, Siemens Medical Solutions) and a standard protocol using prospective triggering. Coronary calcifications were quantified using the volume score (VS). In addition calcifications were described as proximal, mid, or distal according to the AHA segment model. Mean observation time was 5.6 years, range 3.9 to 6.1 years.
Results: Mean VS in the initial scan was 108 ± 88, 138 ± 97 in men and 56 ± 39 in women. In 288 patients coronary calcifications could be excluded. 62 % of calcifications were found in the proximal segments, 26 % in the medial segments, and 12 % in the distal segments.
In the second scan the mean score was significantly increased up to 153 ± 133, 193 ± 160 in men, 85 ± 66 in women, p <0.001. The mean relative increase was 41.6 %, resp. 7.0 % per year. Thereby the absolute increase of volume score correlated to the initial scan value, r = 0.92. 64 patients with an initial exclusion of coronary calcifications developed calcifications, they possessed a mean score of 26 ± 15. During the observation also the local distribution of calcifications changed: 47 % of calcifications were found in the proximal, 36% in the medial, and 17 % in the distal segments.
Conclusion: In this prospective study we observed an increase of 41.6 % over an observation period of 5 years. 22 % of patients with an initial score of 0 developed coronary calcifications during the study. Further it seems, that coronary calcifications develop from proximal to distal segments.
 
Clin Res Cardiol 100, Suppl 1, April 2011
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-011-1100-y

http://www.abstractserver.de/dgk2011/ft/abstracts/P1347.htm