Influence of Calcium Score on the Severity of Moderate Coronary Lesions Evaluated by Intravascular Ultrasound

ABSTRACTBackgroundThe minimal luminal area (MLA) measured by intravascular ultrasound (IVUS) is a predictor of cardiovascular events in patients with angiographically moderate lesions. On the other hand, the presence of calcium is a predictor of lesion stability. The objective of this study is to evaluate the influence of the total amount of coronary calcium, obtained by multislice CT scanner (MDCT), on the severity of moderate lesions as assessed by IVUS.MethodsIVUS was performed in 27 moderate lesions in a consecutive series of 22 patients with indication for the procedure who had a previous MDCT. Measurements of the minimal luminal area (MLA), plaque burden and percentage area stenosis were obtained.ResultsMost patients were male (85%), with mean age of 60±9 years and 41% were diabetic. A significant correlation was observed between the MLA and total calcium score (r=0.67; P=0.002), but there was no correlation between the total calcium score and plaque burden (r=0.02; P=0.93) or percentage area stenosis (r=0.3; P=0.32). Independent predictors of MLA in the multivariate analysis were age (P=0.02), body mass index (P=0.01), diabetes (P=0.02), dyslipidemia (P=0.02), high-sensitive C-reactive protein (P=0.02), glucose (P=0.02), HDL-cholesterol (P=0.02), triglycerides (P=0.02), left ventricular ejection fraction < 50% (P=0.02) and total calcium score (P=0.03).ConclusionsThe total calcium score correlates positively with MLA in coronary arteries, suggesting that a large calcium burden in the coronary tree is related to angiographically moderate lesions with larger luminal areas at IVUS