Aortic Arch Calcification Is a Strong Predictor of the Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome

Table 1

Baseline characteristics of all patients and patients with low SS (SS ≤22) and intermediate-to-high SS (SS >22).

Variable	All Patients	Low SS	Intermediate-to-high SS	P value
	N = 1,418	N = 821	N = 597
Female gender, n ()	344 (24.3)	203 (24.7)	141 (23.6)	0.503
Age (years)	59±10	58±10	61±11	<0.001
Height (m)	1.69 (1.63–1.73)	1.69 (1.63–1.73)	1.68 (1.62–1.73)	0.269
Weight (kg)	73±12	73±12	72±12	0.427
BMI (kg/m^2)	25.7±3.3	25.7±3.3	25.7±3.3	0.834
Family history of CHD, n ()	428 (30.2)	244 (29.7)	184 (30.8)	0.766
Arterial hypertension, n ()	904 (63.8)	513 (62.5)	391 (65.5)	0.248
Diabetes, n ()	542 (38.2)	260 (31.7)	282 (47.2)	<0.001
Dyslipidemia, n ()	1120 (79.0)	636 (77.5)	484 (81.1)	0.088
History of MI, n ()	148 (10.4)	56 (6.8)	92 (15.4)	<0.001
History of CA, n ()	90 (6.3)	44 (5.4)	46 (7.7)	0.066
Known PVD, n ()	122 (8.6)	31 (3.8)	91 (15.2)	<0.001
COPD, n (%)	18 (1.3)	12 (1.5)	6 (1.0)	0.461
Smoking				0.012
Never smokers, n (%)	592 (41.7)	339 (41.3)	253 (42.4)
Former smokers, n (%)	158 (11.1)	76 (9.3)	82 (13.7)
Current smokers, n (%)	668 (47.1)	406 (49.5)	262 (43.9)
ACS types				0.002
UA, n (%)	980 (69.1)	595 (72.5)	385 (64.5)
NSTEMI, n (%)	204 (14.4)	100 (12.2)	104 (17.4)
STEMI, n (%)	234 (16.5)	126 (15.3)	108 (18.1)
Medical measurements (on admission)
SBP (mmHg)	130±17	130±17	130±17	0.999
DBP (mmHg)	76±11	77±11	75±11	0.021
Laboratory measurements (on admission)
CK-MB (ng/ml)	1.3 (0.9–1.9)	1.2 (0.9–1.9)	1.4 (0.9–2.0)	0.015
cTnI (ng/ml)	0 (0–0.02)	0 (0–0.01)	0.01 (0–0.04)	<0.001
BNP (pg/ml)	36 (22–87)	33 (20–67)	43 (23–108)	<0.001
WBC count (10^9/L)	6.43 (5.38–7.67)	6.41 (5.42–7.68)	6.47 (5.33–7.67)	0.651
Fibrinogen (g/L)	3.22 (2.80–3.68)	3.16 (2.77–3.55)	3.31 (2.92–3.82)	<0.001
CRP (mg/L)	1.37 (0.55–4.10)	1.23 (0.51–3.43)	1.67 (0.63–5.64)	<0.001
Laboratory measurements (fasting state)
TC (mmol/L)	4.18±1.02	4.18±1.01	4.18±1.02	0.885
LDL-C (mmol/L)	2.49±0.83	2.46±0.83	2.53±0.83	0.121
HDL-C (mmol/L)	1.00 (0.87–1.17)	1.02 (0.87–1.18)	0.97 (0.86–1.16)	0.003
TG (mmol/L)	1.43 (1.03–2.10)	1.51 (1.05–2.13)	1.37 (1.00–1.98)	0.012
FPG (mmol/L)	5.13 (5.66–6.99)	5.49 (5.05–6.64)	5.99 (5.26–7.45)	<0.001
HbA1c (%)	5.9 (5.5–6.9)	5.8 (5.5–6.6)	6.2 (5.6–7.4)	<0.001
CrCl (ml/min)	102±31	104±32	98±28	<0.001
LVEF ()	65 (60–68)	65 (60–69)	64 (60–68)	<0.001
Medications use (before admission)
Antiplatelet drugs, n (%)	982 (69.3)	559 (68.1)	423 (70.9)	0.322
HMG-CoA inhibitors, n (%)	958 (67.6)	545 (66.4)	413 (69.2)	0.326
ACE inhibitors/ARBs, n (%)	350 (24.7)	198 (24.1)	152 (25.5)	0.587
Beta-blockers, n (%)	517 (36.5)	270 (32.9)	247 (41.4)	0.002
CCBs, n (%)	467 (32.9)	248 (30.2)	219 (36.7)	0.008
Insulin, n (%)	202 (14.2)	76 (9.3)	126 (21.1)	<0.001
Sulfonyl Urea, n (%)	122 (8.6)	57 (6.9)	65 (10.9)	0.013
Biguanides, n (%)	136 (9.6)	72 (8.8)	64 (10.7)	0.276
Alpha-glucosidase inhibitors, n (%)	98 (6.9)	44 (5.4)	54 (9.0)	0.006
Angiographic characteristics
Left-main disease, n (%)	116 (8.2)	18 (2.2)	98 (16.4)	<0.001
Three-vessel disease, n (%)	786 (55.4)	294 (35.8)	492 (82.4)	<0.001
Proximal LAD stenosis, n (%)	780 (55.0)	321 (39.1)	459 (76.9)	<0.001
Trifurcation or bifurcation lesions, n (%)	1094 (77.2)	554 (67.5)	540 (90.5)	<0.001
Total occlusions, n (%)	390 (27.5)	130 (15.8)	260 (43.6)	<0.001
Heavy calcification lesions, n (%)	432 (30.5)	116 (14.1)	316 (52.9)	<0.001
Lesions length >20mm, n (%)	750 (52.9)	323 (39.3)	427 (71.5)	<0.001
AAC grades				<0.001
Grade 0, n (%)	407 (28.7)	383 (46.7)	24 (4.0)
Grade 1, n (%)	524 (37.0)	349 (42.5)	175 (29.3)
Grade 2, n (%)	390 (27.5)	76 (9.3)	314 (52.6)
Grade 3, n (%)	97 (6.8)	13 (1.6)	84 (14.1)

SS: SYNTAX score; BMI: body mass index; CHD: coronary heart disease; CA: cerebrovascular accident; PVD: peripheral vascular disease; COPD: chronic obstructive pulmonary disease; MI: myocardial infarction; UA: unstable angina; NSTEMI: non-ST-segment elevation myocardial infarction; STEMI: ST-segment elevation myocardial infarction; SBP: systolic blood pressure; DBP: diastolic blood pressure; CK-MB: creatine kinase isoenzyme MB; cTnI: cardiac troponin I; BNP: brain natriuretic peptide; WBC: white blood cell; CRP: C-reactive protein; TC: total cholesterol; LDL-C: low-density lipoprotein-cholesterol; HDL-C: high-density lipoprotein-cholesterol; TG: triglyceride; FPG: fasting plasma glucose; HbA1c: glycated haemoglobin A1c; CrCl: creatinine clearance; LVEF: left ventricular ejection fraction; ACE: angiotensin converting enzyme; ARBs: angiotensin II receptor blockers; CCBs: calcium channel blockers; LAD: left anterior descending; AAC: aortic arch calcification.