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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Coronary artery CT calcium score assessed by direct calcium quantification using atomic absorption spectroscopy and compared to macroscopic and histological assessments

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  • Alexandra G Gheorghe
  • Christina Jacobsen
  • Ragnar Thomsen
  • Kristian Linnet
  • Niels Lynnerup
  • Claus B Andersen
  • Andreas Fuchs
  • Klaus F Kofoed
  • Jytte Banner
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The Agatston score (AS) is the gold standard CT calcium scoring method in clinical practice. However, the AS is an indirect method of determining calcium amount, whereas atomic absorption spectroscopy (AAS) can directly measure the calcium amount. Our primary aim was to investigate the association between the AS and the coronary calcium amount measured by AAS. Furthermore, we compared our outcome to the macroscopic and histological coronary calcification and stenosis assessment, thus allowing us to infer a clinical coronary artery status based on post-mortem findings. Deceased individuals were examined with a 64-slice multidetector CT scanner, and the AS was determined. At autopsy, the degree of CAC and stenosis was determined, and the coronary arteries were excised and weighed. The coronary arteries were decalcified in a solution that was examined using AAS to measure the calcium amount. The degree of CAC and stenosis was also assessed by a histological examination. One hundred thirty-two coronary arteries were examined, and AS was highly correlated to the coronary calcium amount, measured by AAS, (r2 = 0.72, Pearson 0.85, p < 0.0001). In cases with AS 0, AAS measurements showed zero or very low calcium amounts. AS was also correlated to macroscopic and histological calcification assessments (Spearman's rho 0.68, p < 0.0001, Spearman's rho 0.82, p < 0.0001). Furthermore, an underestimation of subclinical atherosclerosis was seen and AS 0 could not rule out stenosis.

Original languageEnglish
JournalInternational Journal of Legal Medicine (Print)
Volume133
Issue number5
Pages (from-to)1485-1496
Number of pages12
ISSN0937-9827
DOIs
Publication statusPublished - Sep 2019

    Research areas

  • Agatston score, Atomic absorption spectroscopy, Calcium scoring, Coronary artery calcification, Coronary artery disease, Coronary calcium scoring method

ID: 58358192