Hubungan antara Coronary Artery Calcium Score (CACS) dengan Disfungsi Diastolik pada Pasien Penyakit Jantung Koroner Stabil di RSUP H. Adam Malik Medan

Abstract

Background: Coronary artery calcium score (CACS) is a specific indicator of coronary atherosclerosis that plays a role in assessing the degree of calcification in atherosclerosis. Diastolic function is the first aspect of cardiac function to be impaired in ischemic heart disease. This study aims to determine the relationship between calcium scoring and diastolic dysfunction. Methods: This study is an analytical observational study with a cross-sectional design aimed at evaluating the relationship between coronary artery calcium score (CACS) and left ventricular diastolic function in patients with stable coronary artery disease (CAD). Data were collected retrospectively from the medical records of patients at RSUP H. Adam Malik Medan during the period of November 2023 – November 2024. CACS assessment was performed using coronary CT scan, while left ventricular diastolic function was measured using echocardiography. Data analysis using chi-square test, Mann-Whitney U test, and ROC curve analysis to evaluate the CACS threshold in predicting diastolic dysfunction. Results: Among 158 analyzed samples, 113 patients (71.5%) had diastolic dysfunction. A calcium score ≥100 was found in 46.2% of patients, who had a 1.318 times higher risk of experiencing diastolic dysfunction compared to those with a score <100 (p = 0.006; 95% CI 1.083–1.605). ROC analysis showed that CACS had a moderate predictive ability for diastolic dysfunction with an area under the curve (AUC) of 0.647 (p = 0.004). A calcium score threshold of 45 had a sensitivity of 65.5% and specificity of 62.2% in detecting diastolic dysfunction. Additionally, type 2 diabetes mellitus, urea, and creatinine levels were also significantly associated with diastolic dysfunction (p < 0.05). Conclusion: There is a significant relationship between calcium score and diastolic dysfunction in patients with stable CAD. Calcium scoring can serve as a potential indicator for predicting diastolic dysfunction in patients undergoing coronary CT scan.