Coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD) are commonly linked. Coronary artery wall calcification might be a sign of heart illness when using computed tomography (CT) for COPD phenotyping. However, the non-ECG gated scans utilized for COPD monitoring do not adhere to recognized quantitative methods employing the Agatston score and ECG-triggered CT. For a study, researchers investigated the diagnostic utility of Agatston scores from cardiac non-triggered images.

A subset of the COPD cohort COSYCONET that received CT scans in addition to thorough clinical evaluations, echocardiographic data, and doctor-based diagnoses of comorbidities made comprised the study population. Through the use of ROC analysis, the Agatston scores from non-contrast-enhanced, non-triggered CT were utilized to establish a cut-off value for CAD.

There were 399 patients total (152 women, 66.0±8.2 years on average). For CAD, an Agatston score of ≥1500 AU or less worked best (AUC 0.765; 95% CI: 0.700, 0.831) and outperformed the standard cut-off value (400 AU). A bronchitis phenotype indicated by changes in lung function left atrial diameter, left ventricular end-systolic diameter, and central airway wall thickness using the value to define groups (P<0.05). In a multivariate analysis, CAD was predicted by BMI, hyperlipidemia, arterial hypertension, GOLD D (P< 0.05), but especially by an Agatston score 1,500 AU (odds ratio 10.5; 95% CI: 4.8; 22.6).

The cut-off value for actionable coronary artery disease in COPD patients using Agatston scores produced from non-ECG gated CT was substantially higher (1,500 AU) than in cardiology patients using Agatston scores derived from ECG-triggered CT, according to the findings.

Reference: resmedjournal.com/article/S0954-6111(22)00279-7/fulltext