Objective To explore the calcification scores of coronary artery CT angiography (CTA) in evaluating coronary artery lesions and prognosis in patients with chronic angina pectoris (CAP).
Methods A total of 160 patients with CAP in our hospital were collected and received the examinations of intravascular artery ultrasound (IVUS) and CTA. Regarding the coronary IVUS as golden standard, the accuracy of the calcification scores of coronary CTA in evaluating the stability of coronary plaque was analyzed. The correlation of calcification scores of coronary CTA with stability of coronary plaque was analyzed by Pearson linear correlation analysis. Multivariate Logistic regression analysis was used to determine the risk factors for acute coronary syndrome (ACS) in CAP patients at 12 months of follow-up. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of calcification score of coronary artery CTA for CAP patients with ACS at 12-month of follow-up.
Results The occurrences of lipid plaques and fibrous plaque showed no significant difference between two examinations (P>0.05). However, the detection result of calcification score of coronary CTA on calcified plaque was better than that of coronary IVUS (P=0.004). Using IVUS as the gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of calcification score of coronary artery CTA for the diagnosis of coronary artery vulnerable plaques were 81.4%, 69.4%, 42.9% and 92.9%, respectively. Pearson correlation analysis showed that coronary artery CTA calcification score was positively correlated with plaque stability (P < 0.05). Multivariate Logistic regression analysis showed that plaque nature and calcification score of coronary artery CTA were the influencing factors for ACS in CAP patients after followed-up for 12 months (OR=2.872, 0.559, P=0.020, 0.012). ROC curve showed that the cut-off value of CTA calcification score was 385.5, and the area under the curve to predict the occurrence of ACS in CAP patients during the follow-up of 12 months was 0.849, the sensitivity was 87.4%, and the specificity was 79.2%.
Conclusion The calcification scores of coronary CTA can assess the stability of coronary plaque, and has higher accuracy in evaluating short-term prognosis of patients with CAP.
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