Coronary calcification compared in patients with acute versus in those with chronic coronary events by using dual-sector spiral CT

Radiology. 2003 Feb;226(2):483-8. doi: 10.1148/radiol.2262011903.


Purpose: To compare underlying calcific atherosclerotic lesions in acute versus chronic coronary events in patients with hypertension by using dual-sector spiral computed tomography (CT).

Materials and methods: Eight hundred eighty-four calcific lesions were analyzed in a cohort of 50 patients (39 men, 11 women; age range, 55-79 years; mean age, 66 years +/- 6 [SD]) with hypertension who sustained a coronary event during 3-year follow-up. All underwent dual-sector spiral CT within 12 months before the event. Twenty-nine patients had an acute event (acute group): acute myocardial infarction, 20; unstable angina pectoris, six; acute ischemia, two; sudden death, one. Twenty-one patients had chronic manifestations of obstructive coronary disease (chronic group): severe stable angina, five; angiographically identified disease, 12; disease requiring angioplasty, two; and disease requiring bypass surgery, two. To examine differences between the two study groups, the chi(2) or Fisher exact test was applied to categorical parameters and the two-sample t test or Wilcoxon rank sum test to quantitative parameters.

Results: High prevalence of coronary calcium (total coronary calcium score [TCS] >0) was observed in both groups: 93% (27 of 29) in the acute and 95% (20 of 21) in the chronic group. There were 518 lesions in the chronic and 366 in the acute group, with a median number of 35 and nine lesions per patient, respectively (P <.001). The median TCS was 906 for the chronic and 63 for the acute group (P <.01).

Conclusion: A mild degree of calcification characterizes patients with acute coronary events, while diffuse high-attenuation calcific plaques are associated with chronic coronary events.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Aged
  • Calcinosis / complications
  • Calcinosis / diagnostic imaging*
  • Chi-Square Distribution
  • Chronic Disease
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / etiology
  • Disease Progression
  • Female
  • Humans
  • Hypertension / complications
  • Male
  • Middle Aged
  • Statistics, Nonparametric
  • Tomography, Spiral Computed*