Ordinal Scoring of Coronary Artery Calcification by Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism

Objective To assess coronary artery calcification (CAC) in patients with acute pulmonary embolism and determine whether this correlates with right ventricular dilation (RVD) and mortality. Methods Computed tomography pulmonary angiography scans of 330 patients were used to perform retrospective assessment of the pulmonary artery computed tomography obstruction index (PACTOI), the right/left ventricle diameter ratio, the diameter of the pulmonary trunk, and the ordinal CAC score. Results Age (P < 0.001), urea level (P < 0.001), D-dimer level (P = 0.006), diameter of the pulmonary trunk (P < 0.001), and PACTOI (P < 0.001) were significantly higher in the RVD-positive patient group. We found a significant relation between increased CAC score and increased mortality (P = 0.038). Left-sided CAC was detected much more often in RVD-positive patients (P = 0.008). Conclusions Coronary artery calcification is common in patients with acute pulmonary embolism, especially when those patients are also RVD-positive. A significant relation was found between RVD and left-sided CAC.