Atherosclerosis is a systemic condition that causes death globally. Medium and large arteries, such as the carotid and coronary arteries, are usually affected. 52% of acute ischemic stroke (AIS) patients are non-symptomatic CAD. Two-thirds of patients suffering from AIS with no history of cardiac symptoms have coronary artery disease (CAS), and 3% of AIS patients have an increased chance of myocardial infarction[1–3]. The CAD risk associated with vascular involvement over two years is 50% higher in AIS individuals without coronary atherosclerosis. The chance of CAD combined with a vascular disease don't have cardiac symptoms is 4.36 times higher[4, 5]. Arterial calcification is a common finding in computed tomography angiography (CTA) patients with AIS. Intracranial artery calcifications indicate subclinical CAD due to their substantial correlation with the coronary artery calcium score (CACS). Coronary heart disease (CHD) is the main mortality risk in developed countries and the United States.CHD causes severe pathogenicity, disability, and loss of efficiency and productivity, culminating in a rise in healthcare costs. The spectrum of CHD ranges from sudden cardiac death (SCD), ischemic cardiomyopathy (ICM), acute myocardial infarction (AMI), unstable angina, chronic stable angina to silent myocardial ischemia (SMI), and Mortalities caused by CHD have been declined remarkably over the past decades with the advent of novel modalities and surgical procedures[1, 2, 6].
Monitoring and studying fast cardiac cycles requires advanced imaging tools such as cardiac gating or ECG-gated angiography to trigger scans and collect data during specific phases of the cardiac cycle. By this technique, With this technique, patients no longer need to be hospitalized, compared to geography [7]. Coronary computed tomography angiography (CCTA) is a reliable non-invasive method for diagnosing and excluding artery disease (CAD) [8, 9]. In addition to coronary stenosis, CCTA helps detect coronary atherosclerosis extent, severity, distribution, and composition. These imaging results add incremental value for predicting future adverse outcomes beyond clinical factors. Applications today frequently use many slices[3, 6].
The ability of CAC scoring, a well-known technique, to categorize the chance of mortality from cardiovascular disease is exceedingly crucial. The best instrument for risk discrimination has continuously been demonstrated to be CAC in several sizable international registries[4]. Studies have connected coronary artery calcium (CAC) to increased heart attacks. The number of vessels in the coronary artery disease (CAD) was calculated as the proportion of each of the three major coronary arteries having a stenosis area of 70% or more. Before contrast media injection, radio opacities inside the vascular walls that were evident in many projections on the cine were thought to be indicators of significant coronary artery calcification. The SYNTAX classification provided a precise characterization of severe calcification[6]. For example, a calcium score (CS) of > 400 signifies a high cardiovascular event risk. So, it's necessary to take measures to prevent the formation of coronary plaques and advanced atherosclerosis. A higher CS is a hallmark of heart vessel narrowing or blockage [7]. A zero CS does not negate the presence of soft plaques but rejects the likelihood of CHD in the patient. CS is not a basis for the present existence, and such plaques are better seen in coronary CT angiography (CTA). But, a high CS alarm for soft plaques in coronary arteries. Soft plaque destabilization is a common cause of acute coronary syndrome (ACS). CS is a single criterion employed in routine cardiac CT scans [7].
A systematic review in Canada in 2010 showed that cardiac MRI (CMR) could be a potent possible assess coronary artery involvements for its sensitivity and reliable diagnostic properties, as well as no exposure to ionizing radiation [10]. A 2011 review by Konstantin Nikolaou and colleagues showed that CMR is an accurate and low-risk technique with optimal specificity and sensitivity to measure the severity of coronary artery stenosis [11]. Ganigara et al. (2016) studied patients in Australia and found that CMR can be used to diagnose and follow up on structural heart diseases[5]. Considering the above topics, we aim to investigate the relationship between LM, LAD, and LCX involvements and calcification in CHD patients.