1. Mean Versus Peak Coronary Calcium Density on Non-Contrast CT
- Author
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Alan Rozanski, Olufunmilayo H. Obisesan, Khurram Nasir, Leslee J. Shaw, Martin Bødtker Mortensen, Ellen Boakye, Matthew J. Budoff, Seamus P. Whelton, Michael D. Miedema, Zeina Dardari, Alexander C. Razavi, Michael J. Blaha, Omar Dzaye, Daniel S. Berman, and John A. Rumberger
- Subjects
medicine.medical_specialty ,business.industry ,Non contrast ct ,Area under the curve ,nutritional and metabolic diseases ,chemistry.chemical_element ,Coronary calcium ,Calcium ,Net reclassification improvement ,Coronary artery calcium ,Calcium scoring ,chemistry ,Hounsfield scale ,Internal medicine ,Cardiology ,medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives This study sought to assess the relationship between mean vs peak calcified plaque density and their impact on calculating coronary artery calcium (CAC) scores and to compare the corresponding differential prediction of atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD) mortality. Background The Agatston CAC score is quantified per lesion as the product of plaque area and a 4-level categorical peak calcium density factor. However, mean calcium density may more accurately measure the heterogenous mixture of lipid-rich, fibrous, and calcified plaque reflective of ASCVD risk. Methods We included 10,373 individuals from the CAC Consortium who had CAC >0 and per-vessel measurements of peak calcium density factor and mean calcium density. Area under the curve and continuous net reclassification improvement analyses were performed for CHD and ASCVD mortality to compare the predictive abilities of mean calcium density vs peak calcium density factor when calculating the Agatston CAC score. Results Participants were on average 53.4 years of age, 24.4% were women, and the median CAC score was 68 Agatston units. The average values for mean calcium density and peak calcium density factor were 210 ± 50 Hounsfield units and 3.1 ± 0.5, respectively. Individuals younger than 50 years of age and/or those with a total plaque area 100. Conclusion Mean and peak calcium density may differentially describe plaque composition early in the atherosclerotic process. Mean calcium density performs better than peak calcium density factor when combined with plaque area for ASCVD mortality prediction among persons with Agatston CAC 1-99.
- Published
- 2022