الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Ischemic heart disease is the leading cause of death worldwide. CHD is the largest contributor of cardiovascular diseases (CVDs) and mortality rate is due to prevalence to atherosclerosis, a chronic inflammatory condition of the arterial wall. Atherosclerosis has many complications like arterial stenosis, thrombosis and atheromatous plaque complication.
CAC is a risk factor for adverse outcomes in the general population and in patients with coronary artery disease. CAC is specifically related to atherosclerosis, and its extent is a good marker of the total burden of coronary atherosclerosis. (174) Measurement of CAC has consistently proven to be the best subclinical CVD measure in terms of improving CHD risk prediction.
CT is the only noninvasive test with high sensitivity and specificity for calcium detection and is capable of quantifying calcification. (85) CT-scan–based calcium scores added prognostic value for predicting cardiac death and MI, especially in patients at intermediate probability for developing cardiovascular events.
Statins have not been shown to stop the progression or affect the natural history of CAC. Further studies are needed to determine whether novel systemic therapies benefit patients with CAC. Although the advent of DES has led to improved outcomes after PCI of CAC, long-term MACE rates remain high also severe CAC poses technical challenges to the surgeon as well, and results are suboptimal.
The aim of this study is to determine the prevalence of heavy calcification in the Egyptian patients by MSCT, their clinical characteristics and the relation to their clinical outcomes.
The study was conducted on 500 symptomatic patients retrospectively from the beginning of January 2010 till the end of March 2017 and prospectively from the beginning of April 2017 till the end of September 2017, all of them were screened for traditional risk factors and were evaluated with MSCT and then were followed up for a period ranged 12 to 24 months for the development of major and minor cardiovascular events.
In the 500 consecutive patients the mean age was 58.2±10.85 years, 283 (56.6%) were males and 217 (43.4%) were females.
The patient population was classified according to their CACS into heavy calcification group (>400 HU) and non-heavy calcification group (≤400 HU).
In the heavy calcification group 70.8% were males and 29.2% were females while in the non-heavy group 52.1% were males and 47.9% were females. The mean age in the heavy calcification group was 64.85 ± 8.35 while that in the non-heavy one was 56.11 ± 10.71.
In the heavy group 82%, 72.1% and 72.1% of patients were taking B-blockers, aspirin and statins respectively in comparison to 44.4%, 27.9% and 47.1% in the non-heavy group