Relationship between coronary calcium score and high-risk plaque/significant stenosis

Table 1 Clinical characteristics of studied patients n (%)

CCS	0	1-100	101-400	> 400	P
n	154	198	165	134
Age	63.1 ± 11.7	68.2 ± 8.5	69.6 ± 9.8	71.5 ± 8.1	< 0.0001
Male sex	76 (49.4)	137 (69.2)	121 (73.3)	98 (73.1)	< 0.0001
Risk factor
Hypertension	85 (55.2)	125 (63.1)	115 (69.7)	99 (73.9)	0.0045
Dyslipidemia	88 (57.1)	124 (62.6)	105 (63.4)	82 (61.2)	0.6484
Diabetes	53 (34.4)	76 (38.4)	65 (39.4)	76 (56.7)	0.0007
Stroke	36 (23.4)	58 (29.3)	58 (35.2)	58 (43.3)	0.0024
CKD	30 (19.5)	47 (23.7)	47 (28.5)	43 (32.1)	0.07
BMI (kg/m2)	25.7 ± 3.7	24.4 ± 2.6	24.2 ± 3.7	23.8 ± 4.8	0.2514
Laboratory data
HbA1c (mmol/mol)	46.1 ± 13.4	47.4 ± 14.5	48.5 ± 13.0	48.9 ± 12.0	0.3286
BS (mmol/L)	7.43 ± 2.37	7.73 ± 2.44	7.94 ± 2.39	8.52 ± 2.99	0.0333
TC (mmol/L)	5.24 ± 0.99	5.13 ± 0.99	4.95 ± 0.98	4.72 ± 0.87	0.0054
TG (mmol/L)	1.69 ± 1.12	1.63 ± 1.01	1.73 ± 0.94	1.72 ± 0.90	0.8925
HDL-C (mmol/L)	1.50 ± 0.51	1.47 ± 0.43	1.29 ± 0.30	1.41 ± 0.39	0.0084
LDL-C (mmol/L)	3.18 ± 0.86	2.93 ± 0.91	2.96 ± 0.85	2.68 ± 0.72	0.0023
Cr (μmol/L)	69.0 ± 28.3	73.4 ± 19.4	75.1 ± 17.7	78.7 ± 21.2	0.0481
Medication
ARB/ACE-I	70 (45.5)	101 (51.0)	98 (59.4)	97 (72.4)	< 0.0001
CCB	53 (34.4)	98 (49.5)	96 (58.2)	95 (70.9)	< 0.0001
Diuretics	5 (3.2)	10 (5.1)	9 (5.5)	7 (5.2)	0.7883
Beta-blocker	3 (1.9)	5 (2.5)	3 (1.8)	4 (3.0)	0.9096
Aspirin	37 (24.0)	60 (30.3)	61 (37.0)	60 (44.8)	0.0013
Statin	85 (55.2)	119 (60.1)	100 (60.6)	79 (59.0)	0.7559
Oral diabetics	51 (33.1)	76 (38.4)	65 (39.4)	76 (56.7)	0.0004
Insulin	10 (6.5)	15 (7.6)	16 (9.7)	19 (14.2)	0.112

CCS: Coronary calcium score; ACE-I: Angiotensin converting enzyme inhibitor; ARB: Angiotensin receptor blocker; BMI: Body mass index; BS: Blood sugar; CCB: Calcium channel blocker; DM: Diabetes mellitus; HbA1c: Hemoglobin A1c; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; TC: Total cholesterol; TG: Triglyceride.

Table 2 Incidence of high-risk plaque among the four groups n (%)

CCS	0	1-100	101-400	> 400	P
n	154	198	165	134
High-risk plaque	2 (1.3)b	20 (10.1)	22 (13.3)	18 (13.4)	0.0171
Positive remodeling	2 (1.3)d	20 (10.1)	21 (12.7)	18 (12.7)	< 0.001
Low attenuation plaque	0 (0)e	7 (3.5)	4 (2.4)	1 (0.7)	0.0217
Spotty calcification	0 (0)h	13 (6.6)	11 (6.7)	8 (6.0)	< 0.001
Napkin-ring sign	0 (0)i	7 (3.5)	2 (1.2)	1 (0.7)	0.0474
Multiple plaques	0 (0)	4 (2.0)	3 (1.8)	3 (2.2)	0.166
%APV	30.5 ± 24.3	42.5 ± 9.0	44.8 ± 9.2	42.2 ± 7.8	0.2537

^bP = 0.0016 compared with group with CCS 1-100;

^dP = 0.0016 compared with group with CCS 1-100;

^eP = 0.0486 compared with group with CCS 1-100;

^hP = 0.0031 compared with group with CCS 1-100;

ⁱP = 0.0486 compared with group with CCS 1-100. CCS: Coronary calcium score; %APV: Percent aggregate plaque volume.

Table 3 Predictors of high-risk plaque, significant stenosis, and high-risk coronary calcium score by multivariate analysis

	OR	95%CI	P
High-risk plaque factor
Male	4.93	2.07-11.7	0.0003
Hypertension	2.2	1.13-4.28	0.0204
Significant stenosis factor
Hypertension	2.66	1.44-4.89	0.0017
Dyslipidemia	2	1.15-3.47	0.0137
Diabetes	2.32	1.42-3.79	0.0008
High-risk CCS factor
Age	1.06	1.03-1.08	0.00001
Male	1.54	1.02-2.34	0.0414
Diabetes	2.46	1.68-3.59	0.0001

CCS: Coronary calcium score.

Table 4 Major coronary event among the four groups n (%)

CCS	0	0-100	101-400	> 400	P
n	154	198	165	134
MCE	0 (0)	8 (4.0)a	13 (7.9)c	23 (17.2)f	< 0.001
Coronary death	0 (0)	0 (0)	0 (0)	1(0.8)	0.6345
Myocardial infarction	0 (0)	1 (0.5)	1 (0.6)	3 (2.2)	0.4584
Revascularization	0 (0)	7 (3.5)g	12 (7.3)i	19 (14.2)k	< 0.001

^aP = 0.0306 compared with group with CCS 0;

^cP= 0.1188 compared with group with CCS 1-100;

^fP = 0.0141 compared with group with CCS 101-400;

^gP = 0.0486 compared with group with CCS 0;

ⁱP = 0.1114 compared with group with CCS 1-100;

^kP = 0.0333 compared with group with CCS 101-400. CCS: Coronary calcium score; MCE: Major coronary event.