CORONARY ARTERY CALCIFICATION

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Abstract
The incidence and significance of coronary artery calcification were determined on the basis of television monitored cineroentgenographic studies of hearts of 1,097 patients over the age of 40 yr. As the study progressed, it became increasingly apparent that the identification of coronary artery calcification is related not only to intrinsic factors such as the quality of the television picture and the cine-reproduction, but also to the skill and experience of the observer. The over-all incidence of coronary artery calcification in patients over 40 years of age is 15%. It is more common in males by a ratio slightly greater than 3:2. The incidence of calcification of the coronary arteries increases with increasing age. Coronary artery disease is frequently present in the absence of identifiable coronary artery calcification. Thus, absence of recognizable coronary artery calcification is unreliable in excluding the presence of coronary artery disease. However, the incidence of coronary artery disease in patients with coronary artery calcification is greater than in those without calcification. Further, when broken down by decades there is a strikingly high incidence of coronary artery disease in young patients with coronary artery calcification. In patients under the age of 60 years, the incidence of coronary artery disease in those with calcified coronary arteries is 52%, whereas in those without calcification it is only 21%. In patients over the age of 60 years, the incidence of coronary artery disease in the calcified and noncalcified group is nearly equal. A relationship exists between the incidence of coronary artery disease and the number of coronary arteries calcified. In patients with noncalcified coronary arteries, the incidence of coronary artery disease is 33%, with one artery calcified 48%, and with both arteries calcified 66%. Cineroentgenographic detection of calcification of the coronary artery may be considered as an alarm signal of potential ischemic heart disease in asymptomatic patients with a normal electrocardiogram. It is, therefore, recommended that a search for coronary artery calcification with image intensification be carried out as a routine screening procedure in all fluoroscopic examinations.