The Diagnostic Value of the Relationship between Lipid Profile, the Different Grades of Coronary Calcification and Stenosisin Patients with Possible CAD

2021 
Background:Coronary calcification is an important risk factor for adverse outcomes in the general population (1, 2). Coronary calcification causes reduction in the vascularcompliance (3). Prediction of the severity of CAD is valuable due to the increased risk for cardiovascular events CT scan of the coronary arteries allows assessment of the degree of coronary calcification as well as the degree of stenosis and the type of plaque (calcific or non-calcific)(6) Objectives:To investigate the relationship between the lipid profileparameters and thedifferent grades of coronary calcification,using MSCT and correlate them withthe significance of coronary stenosis during coronary angiography in patients suspected to have coronary artery disease. Subjects and Methods:Our study included 300 adult symptomatic patients, in the period between January 2017 and February 2018.  Lipid profile for each patient was registered, calcium score was calculated for each patient, including areas with a density above 130 HUusing (Agatston score),we divided the study population into 2 categories (one group having calcium score above 400 and the other group having  calcium score below 400)for a better correlation. After calculating the calcium score, coronary catheterization was done for the assessment of the significance of coronary stenosis,significant lesions were defined as greater than 70% reduction in the luminal diameter, the time interval between catheterization and CT scan was not more than one week. The correlation between the lipid profile parameters and the degree of coronary calcification as well as the significance of coronary stenosis was established. Results:Serum cholesterol, LDL and triglycerides had a strong positive correlation with the total calcium score, whereas HDL had a strong negative correlation with the total calcium score (p value <0.001). Serum cholesterol, LDL and Triglycerides were also significantly higher in the group of patients having significant lesions (p value<0.001), whereas HDL level was significantly lower in the group of patients having significant stenosis (p value<0.001). Age was significantly higher in the group of high calcium score (agatston score >400), the number of hypertensive and diabetic patients was higher in the group of patients with high calcium score (agatston score>400),the number of patients with a positive family history of ischemic heart diseases was higher in the group of highcalcium score (agatston score>400). Conclusion:dyslipidemia was found to be an important predictor for coronary calcification (detected by CT scan) as well as the presence of significant coronary artery stenosis (detected by coronary angiography)
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