Prior to CCTA, all patients underwent a noncontrast-enhanced cardiac CT for the evaluation of coronary calcifications using the Agatston method. The CCTA technique was chosen individually for each patient depending on heart rate and/or rhythm and body mass index, with the goal of minimizing radiation exposure while maximizing diagnostic image quality.
The calcium score was calculated by using dedicated software according to the Agatston method. All contrast-enhanced CCTA data were reconstructed with a section thickness of 0.5 mm in the axial plane with a third-generation iterative reconstruction technique (ADMIRE, Siemens Healthineers, Forchheim, Germany) and a corresponding vascular algorithm (Bv40).