Korelasi Derajat Kalsifikasi Arkus Aorta pada Radiografi Toraks dengan Coronary Artery Calcium (CAC) Score pada CT Jantung Pasien Unstable Angina Pectoris

Nadia Primivita Dirgahayu, Dr. dr. Nurhuda Hendra Setyawan, Sp.Rad, M.Sc.; dr. Anita Ekowati Sp. Rad., Subsp. TR(K)

2026 | Tesis | S2 Kedokteran Klinik

Latar belakang: Unstable angina pectoris (UAP) merupakan manifestasi sindrom koroner akut yang berkaitan dengan aterosklerosis koroner. Kalsifikasi arkus aorta dan arteri koroner merupakan manifestasi aterosklerosis sistemik, sehingga derajat kalsifikasi arkus aorta pada radiografi toraks berpotensi mencerminkan beban kalsifikasi koroner yang dinilai melalui coronary artery calcium (CAC) score pada CT jantung.

Metode: Penelitian analitik observasional dengan desain cross sectional menggunakan data sekunder retrospektif dilakukan pada pasien UAP yang menjalani CT jantung di RSUP Dr. Sardjito Yogyakarta periode Januari 2024-Juni

2026. Sebanyak 52 subjek yang memenuhi kriteria penelitian dipilih secara consecutive sampling. Derajat kalsifikasi arkus aorta dinilai secara semikuantitatif pada radiografi toraks menjadi grade 0-3, sedangkan CAC Score dihitung menggunakan metode Agatston pada CT jantung nonkontras ECG-gated. Hubungan kedua variabel dianalisis menggunakan uji korelasi, dilanjutkan analisis stratifikasi.

Hasil: Median usia subjek adalah 63,5 (13,8) tahun dengan proporsi laki-laki 51,9%. Hipertensi dan dislipidemia ditemukan masing-masing pada 90,4?n 84,6% subjek, sedangkan diabetes, merokok, dan anemia masing-masing sebesar 36,5%, 38,5%, dan 11,5%. Terdapat korelasi positif kuat dan bermakna antara derajat kalsifikasi arkus aorta dan CAC Score (r=0,873; p<0 r=0,832) r=0,913), r=0,871) r=0,880), r=0,794) r=0,901),>

Kesimpulan: Derajat kalsifikasi arkus aorta pada radiografi toraks memiliki korelasi positif kuat dengan CAC Score pada pasien UAP dan hubungan tersebut tetap kuat setelah penyesuaian berbagai faktor risiko.

Background: Unstable angina pectoris (UAP) is a manifestation of acute coronary syndrome associated with coronary atherosclerosis. Calcification of the aortic arch and coronary arteries represents a manifestation of systemic atherosclerosis; thus, the grade of aortic arch calcification observed on chest radiography potentially reflects the coronary calcification burden assessed via the coronary artery calcium score (CAC) Score on cardiac CT.

Methods: An observational analytic study with a cross sectional design utilizing retrospective secondary data was conducted on UAP patients undergoing cardiac CT at Dr. Sardjito General Hospital, Yogyakarta, between January 2024 and June 2026. A total of 52 subjects meeting the study criteria were selected via consecutive sampling. The grade of aortic arch calcification was assessed semi-quantitatively on chest radiographs (grades 0–3), while the CAC Score was calculated using the Agatston method on non-contrast, ECG-gated cardiac CT scans. The relationship between the two variables was analyzed using correlation tests, followed by stratified analysis to account for confounding factors.

Results: The median age of the subjects was 63,5 (13,8) years, with 51.9?ing male. Hypertension and dyslipidemia were present in 90.4% and 84.6% of subjects, respectively, while the prevalence of diabetes, smoking, and anemia was 36.5%, 38.5%, and 11.5%, respectively. A strong, significant positive correlation was observed between the degree of aortic arch calcification and the CAC Score (r=0.873; p<0 r=0.832) r=0.913), r=0.871) r=0.880), r=0.794) r=0.901);>

Conclusion: The degree of aortic arch calcification on chest radiography shows a strong positive correlation with the CAC Score in patients with unstable angina pectoris (UAP), and this association remains strong after adjusting for various risk factors.

Kata Kunci : Angina, Unstable; Vascular Calcification; Aorta, Thoracic, Radiography, Thoracic; Tomography, X-Ray Computed.