Coronary artery calcifications: significance of incidental detection on CT scans.

A scoring system was devised for the assessment of coronary artery calcifications apparent on computed tomographic (CT) scans, with width and length used to assess severity. The degree of calcification was compared with the presence of stenoses of 70% or greater at cardiac catheterization in 46 patients who underwent both studies. Although many significantly stenosed vessels showed no calcification, heavy calcifications had a high positive predictive value for significant disease. In a separate branch of the study, the perioperative cardiac morbidity and mortality were compared in 30 age- and sex-matched pairs of patients undergoing thoracotomy who did and did not have coronary calcifications on CT scans obtained before surgery. Patients with calcifications had a higher frequency of cardiac complications, including arrhythmias, ischemia, hypotension, myocardial infarction, and death.