Segmental distribution of calcium scores in the coronary arteries

OBJECTIVES
Calcium accumulation in the coronary arteries is a known indicator of atherosclerosis. The purpose of this study was to demonstrate both the correlation between patients’ demographic characteristics and segmental calcium scores and also dominant topographic accumulation of calcium in the coronary arteries.

STUDY DESIGN
Two-hundred ninety-nine patients were included in the study (192 male, 107 female; mean age 59.08±10.7; range 19 to 84 years). All patients with total calcium scores of 1 Hounsfield unit or more underwent 16-slice multi-detector computed tomography with calcium scoring evaluation. Their coronary trees were divided into 14 different segments, and the number of lesions, and calcium score of each segment were calculated separately.

RESULTS
When the coronary arteries were examined as for segmental calcium accumulation by segment, the proximal segment of the LAD (left anterior descending coronary artery) had the highest calcium accumulation. Total calcium scores were higher in the patients with high total and LDL cholesterol values than in normolipidemic patients. Total calcium scores were higher in patients with hypertension relative to the than for patients without hypertension. Calcium scores of smokers and non-smokers were not significantly different. Diabetic patients had higher calcium scores than patients without diabetes. No significant difference was identified between patients with and without a positive family history of coronary artery disease. Total calcium scores were higher in the advanced age group, and in patients with hyperlipidemia.

CONCLUSION
Segmental analysis of calcium scoring demonstrates that calcium accumulation is mostly seen in the proximal LAD. Coronary artery calcification is observedly increased in the presence of coronary artery risk factors as hypertension, advanced age, and hyperlipidemia.