Predictive value of coronary artery calcification in coronary artery stenosis

Abstract Background: Early diagnosis of CAD could lead to proper treatment of patients and coronary artery calcification is considered to be a valuable index in detecting coronary artery disease using a noninvasive technique. Objective: To evaluate the relation between calcification and stenosis of coronary artery. Methods: This was a cross sectional study in which 760 patients suffering from typical chest pain and as candidates for coronary angiography were evaluated for calcification of coronary artery by fluoroscopy. All patients signed a consent form while the whole procedures were fully explained in a comprehensible language. Following fluoroscopy and angiography, the results were reviewed by two different cardiologists, separately. The presence of any significant stenosis greater than 75% was considered as a sign for severe CAD. The data were analyzed by X2 followed by determination of sensitivity and specificity. Findings: Abnormal angiogram was found in 402 cases of our patients. In general, the positive and negative predictive values for calcification were 81.8% and 26%, respectively. The positive and negative predictive values were 87.1% and 63.4% in females and 79.7 and 47.3% in males respectively. The highest predictive value was seen in patients below 40 years old (100%). Coronary calcification in patients with abnormal coronary angiogram was found to be 5.4 times higher than those with normal angiogram. Conclusion: According to our results, the noninvasive fluoroscopic technique for detection of coronary artery calcification could be regarded as a screening tool to reveal significant coronary involvement.