Tuba KARTAL, ALPASLAN YAVUZ, Mehmet Güli ÇETİNÇAKMAK, CEMİL GÖYA, Metin ÇUBUK

Koroner arter kalsiyum skoru ile koroner arter hastalığı arasındaki ilişkinin çok kesitli bilgisayarlı tomografi ile değerlendirilmesi

Amaç: Koroner arter hastalığı (KAH) gelişmiş ülkelerde en sık ölüm nedeni olup, erken tanı ve tedavisi mortalite ve morbidite oranlarını azaltmada büyük önem taşımaktadır. Biz bu çalışmada multidetektör bilgisayarlı tomografi (MDBT) tetkiki ile KAH olgularındaki klasik risk faktörleri, anjiografi bulguları ve koroner arter kalsiyum skoru arasındaki ilişkinin değerlendirilmesini amaçladık. Yöntemler: Çalışmamızda 141 koroner arter hastasına ait MDBT ile elde edilmiş koroner arter kalsiyum skorları ve anjiografi bulguları retrospektif olarak değerlendirildi. Hastalarda hiperlipidemi, hipertansiyon, diyabet, ailesel koroner arter hastalığı ve sigara kullanma öyküsü gibi klasik koroner risk faktörlerinin varlığı kaydedildi. Hastaların kalsiyum skoru Agatston sınıflamasına göre hesaplandı. Bulgular: Çalışmaya alınan 141 hastanın ortalama yaş 56±12 olup yaş aralığı 17 ile 80 arasında değişmekteydi. Otuz üç (%23) hastada MDBT ile saptanan koroner arter darlık yüzdeleri %50nin üzerinde idi. Diyabet ve hipertansiyon; koroner kalsiyum skoru ile istatistiksel olarak anlamlı korelasyon gösteren (sırasıyla p=0,023 ve p

Evaluation of the relationship between coronary artery calcium score and coronary artery disease by multislice computed tomography

Objective: Coronary artery disease (CAD) is the major cause of deaths in developed countries and early diagnosis and treatment can reduce the mortality and morbidity. In this study, we aimed to investigate the multislice computed tomography (MSCT) evaluation the relationship between well-established risk factors, angiographic features and coronary artery calcium-scores. Methods: Coronary artery calcium-scores and angiography features of 141 CAD patients achieved by MSCT were evaluated retrospectively. Classical coronary risk factors of patients including hyperlipidemia, hypertension, diabetes, family history of CAD and history of smoking were recorded. Calcium-score of patients based on the classification of Agatston was calculated. Results: The mean age of 141 patients was 56±12 years (Range, 17-80). In 33 patients (23%), the percentages of coronary artery stenosis detected by MDCT were over 50%. Diabetes mellitus and hypertension were the sole coronary risk factors that had statistically significant correlation (p=0,023 and p<0.01 respectively) with coronary calcium-score. ROC analysis was performed to evaluate the relationship between coronary artery calcium-score and coronary artery disease severity; area under curve was calculated as 0.842 (95% CI 0.771-0.898, p<0.001). Conclusion: The calcium-score levels below the value of 39 were predicted as substantial variable to rule out significant coronary artery stenosis. Calcium score level of 0, even without the ability to exclude the presence of soft coronary plagues definitely, have the potential to eliminate the necessity of invasive diagnostic procedures for some selected individuals by high sensitivity and negative predictive values.

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