INFLUENCE OF AGE AND GENDER ON THE PRESENCE OF CORONARY CALCIUM DETECTED BY ULTRAFAST COMPUTED-TOMOGRAPHY

Objectives. This study sought to determine the relation between corona ry calcification detected with ultrafast computed tomography and lumen narrowing defined with angiography and evaluated whether this relatio n is influenced by age and gender. Background. Ultrafast computed tomo graphy has been shown to be a sensitive method for detection of corona ry calcification associated with atherosclerotic disease, but the rela tion between the extent of coronary calcification and degree of lumen narrowing and the possible influence of gender or age, or both, on thi s relation have not been clarified. Methods. Seventy men and 70 women were studied with ultrafast computed tomography for analysis of corona ry calcification and coronary angiography. Coronary atherosclerosis wa s considered present if any lumen irregularity was noted on angiograph y, and obstructive coronary artery disease was defined as a lumen diam eter narrowing greater than or equal to 70%. Results. Coronary calcifi cation had a sensitivity of 88% for identification of patients with at herosclerotic disease and 97% for those with obstructive disease, with corresponding specificities of 55% and 41%, respectively. The sensiti vity of coronary calcium for detection of atherosclerotic disease in w omen <60 years old was 50%, significantly less than the 97% sensitivit y in women >60 years old and the 87% sensitivity in men <60 years old (p < 0.05 for each comparison). Logistic regression analysis revealed a 1.81-fold increase in the likelihood of detecting coronary calcifica tion in the atherosclerotic lesions of men compared with those in wome n (95% confidence interval 1.12 to 2.93, p = 0.016) when controlled fo r age and severity of coronary disease by angiography. Conclusions. At herosclerotic lesions in women are less likely to have coronary calciu m than lesions with a similar degree of lumen narrowing in men. Differ ences in the pattern of coronary calcification between men and women m ay provide insight into the gender differences observed in the clinica l development of symptomatic coronary artery disease.