Coronary artery and aortic valve calcification evaluated with cardiac computed tomography in patients with chest pain: Prognostic value in clinical practice

Objective: To determine the relationship between coronary artery calcification (CAC) and aortic valve calcification (AVC) and the development of adverse events in the follow-up of patients with suspected coronary artery disease (CAD). Methods: All consecutive patients referred for coronary computed tomography angiography (CCTA) to evaluate for chest pain were included. Clinical data were collected at the time of the referral. CAC and AVC were quantified by means of the Agatston method. The patients were clinically followed for adverse events (cardiovascular death, acute coronary syndrome, stroke and hospitalization for congestive heart failure). Results: The cohort included 304 patients. Both, CAC and AVC were related to age > 65 years, male sex, hypertension and diabetes mellitus. CAC was also related to smoking habits and dyslipidemia. CAC and AVC were not related to each other (Intraclass correlation coefficient = 0.455 [0.345-0.554]). Patients were followed for a median of 840 days [483-1267] and 23 adverse events were detected. CAC was associated with an increased rate of events, whereas AVC was not. Conclusions: Among patients with chest pain and suspected CAD, both CAC and AVC are correlated with several cardiovascular risk factors (CVRF). CAC but not AVC identifies patients with a worse mid-term prognosis. (C) 2016 Elsevier Ireland Ltd. All rights reserved.