The relationship between carotid and coronary calcification in patients with coronary artery disease

Background Atherosclerosis is a multi-system pathology with heterogeneous involvement. We aimed to investigate the relationship between the presence and severity of carotid and coronary calcification in a group of patients with coronary artery disease. Methods Sixty-three patients presenting with unstable angina or positive stress test for myocardial ischaemia were enrolled in this study. All patients underwent CT scanning of the carotid and coronary arteries using the conventional protocol and Agatston scoring system. Risk factors for atherosclerosis were also analyzed for correlation with the extent of arterial calcification. Results Total coronary artery calcium score (CAC) was several times higher than total carotid calcium score (1274 (1018) vs 6 (124), p = 0 center dot 0001, respectively). The left carotid calcium score correlated strongly with the right carotid calcium score (rho = 0 center dot 69, p < 0 center dot 0001). The total CAC score correlated modestly with the total carotid calcium score (rho = 0 center dot 34, p = 0 center dot 007), in particular with left carotid score (rho = 0 center dot 38, p = 0 center dot 002), but not with the right carotid score. The left coronary calcium score correlated with the right coronary calcium score (rho = 0 center dot 35, p = 0 center dot 004), left carotid calcium score (rho = 0 center dot 33, p = 0 center dot 007) and left carotid calcium score at the bifurcation (rho = 0 center dot 34, p = 0 center dot 006). While hypertension correlated with carotid calcium score, diabetes and dyslipidaemia correlated with left CAC score. Conclusion In patients with coronary disease, the carotid calcification pattern appeared to be similar between the right and left system in contrast to that of the coronary arteries. CAC correlated only modestly with the carotid score, despite being significantly higher. Hypertension was related to carotid calcium score while diabetes and dyslipidaemia correlated with coronary calcification.