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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Assessment of cardiovascular risk status at CT colonography
Jesse A Davila1, C Daniel Johnson, Thomas R Behrenbeck
1Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Insights
Abdominal aorta calcium scores from CT colonography correlate with cardiac risk factors and events. This data can be gathered during routine screening without extra risk or scans.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Preventive Cardiology
Background:
- Aortic calcification is a marker of atherosclerosis.
- CT colonography is a common imaging modality.
- Assessing cardiac risk alongside colonography could improve patient care.
Purpose of the Study:
- To evaluate the association between abdominal aorta calcium scores from CT colonography and cardiac risk factors.
- To determine if these calcium scores predict clinical cardiac events.
Main Methods:
- Retrospective analysis of 467 patients who underwent CT colonography.
- Abdominal aorta calcium scoring using a threshold of 130 HU.
- Correlation with established cardiac risk factors and cardiac events via statistical analysis.
Main Results:
- Significant associations found between aortic calcification and cardiac risk factors (age, smoking, blood pressure).
- Aortic bifurcation calcium scores above 895 significantly predicted myocardial infarction or cardiac death.
- Calcium scores were correlated with age (0.51), pack-years (0.43), and systolic blood pressure (0.29).
Conclusions:
- Abdominal aorta calcification scores derived from CT colonography are linked to cardiac risk factors.
- These scores may serve as a predictor of future cardiac events.
- CT colonography offers an opportunity to gather valuable cardiac risk information non-invasively.
Purpose:
To retrospectively determine whether calcium scores of the abdominal aorta obtained during computed tomographic (CT) colonography relate to Framingham risk factors and clinical cardiac events.
Materials And Methods:
The institutional review board approved the current HIPAA-compliant retrospective study and waived informed consent. Between 1995 and 1998, 480 patients underwent CT colonography; 467 patients were available for assessment. Calcium scores with a threshold attenuation value of 130 HU or greater were recorded for abdominal aorta (suprarenal, infrarenal, and aortic bifurcation regions and total). Patient histories were abstracted for established cardiac risk factors and subsequent cardiac events. Associations between calcium measurements and binary risk factors were assessed with Wilcoxon rank sum test; those with continuous risk factors, with Spearman rank correlation coefficient; and those with combined end points, with Cox proportional hazards model.
Results:
Follow-up data were available for 467 patients with median age of 65 years (range, 34-83 years); 59% (275 of 467) were men. Nine patients had cardiac events subsequent to CT colonography. Results of proportional hazards regression analysis revealed a significant association between myocardial infarction or cardiac event-related death and calcium scores of the aortic bifurcation that exceeded 895, the value for the 75th percentile for this calcium variable (P < .01). Associations with established cardiac risk factors for all four calcium scores were significant (P < .05). Spearman rank correlation coefficients for associations between total calcium score and patient characteristics of age, number of pack-years of smoking, and systolic blood pressure were 0.51, 0.43, and 0.29, respectively (P < .001 for all).
Conclusion:
Aortic calcification scores at CT colonography are significantly associated with established cardiac risk factors and cardiac-related events. This screening information can be obtained without additional scanning or risk to the patient.
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