CORONARY CALCIFICATION AND ITS RELATION TO EXTRACORONARY ATHEROSCLEROSIS IN ASYMPTOMATIC HYPERCHOLESTEROLEMIC MEN

Background. The prevalence of coronary calcifications and extracoronary plaques was studied in patients with asymptomatic hypercholesterolemia. Methods and Results. Ultrafast computed tomography for coronary calcification (presence or absence: calcium score) and echographic assessment of carotid, aortic, and femoral plaques were performed in 111 hypercholesterolemic men: 65% had coronary calcification, 72% had extracoronary plaque. The two lesions were associated as: 1) compared with subjects without coronary calcification, those with calcification had a higher prevalence of aortic (p < 0.05) and femoral (p < 0.01) plaque and of two diseased sites (p < 0.05); 2) the prevalence of coronary calcification was higher in the presence than in the absence of aortic (p < 0.05) or femoral (p < 0.01) plaque and higher in two (p < 0.01) and three diseased (p < 0.05) sites than in no diseased site; 3) the calcium score was higher in the presence than in the absence of carotid (p < 0.05), aortic (p < 0.05), or femoral (p < 0.001) plaque, higher in two (p < 0.001) and three diseased (p < 0.05) sites than in no diseased sites, and higher in two (p < 0.01) than in one diseased site; and 4) the calcium score correlated with femoral plaque (p < 0.001). Overall, the presence of two or three diseased extracoronary sites versus no or one diseased site showed a power of 78% for predicting coronary calcification. Coronary calcium score correlated with age (p < 0.01) and triglycerides (p < 0.05). Conclusions. The close relation between coronary calcium and extracoronary plaques suggests that echography of extracoronary vessels could aid in the screening of coronary atherosclerosis in high-risk, asymptomatic individuals.