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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

Unrequested information from routine diagnostic chest CT predicts future cardiovascular events

Peter C Jacobs1, Martijn J Gondrie, Willem P Mali

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. p.c.a.jacobs@umcutrecht.nl

European Radiology
|May 24, 2011
PubMed

Insights

Subclinical coronary and aortic calcification detected on routine chest CT scans predict cardiovascular disease events. These findings highlight the prognostic value of incidental calcifications in clinical care.

Area of Science:

  • Cardiology
  • Radiology
  • Preventive Medicine

Background:

  • Routine diagnostic chest CT scans can reveal incidental findings like coronary artery calcification (CAC) and aortic calcification (TAC).
  • The clinical significance of these subclinical calcifications, often unrequested, remains largely unknown.
  • This study addresses the prognostic relevance of incidental CAC and TAC in a real-world clinical setting.

Purpose of the Study:

  • To investigate the prognostic value of subclinical coronary artery calcification (CAC) and aortic calcification (TAC) identified on routine diagnostic chest CT scans.
  • To determine if these incidental findings predict future cardiovascular disease (CVD) events in a general clinical care population.
  • To establish the independent predictive power of CAC and TAC for incident CVD.

Main Methods:

  • A multicentre cohort study included 10,410 subjects over 40 years old without a history of CVD.
  • Coronary calcification (CAC score 0-12) and aortic calcification (TAC score 0-8) were semi-quantitatively assessed from routine chest CTs.
  • Cox proportional-hazard models were used to analyze the association between calcification scores and 240 fatal or 275 non-fatal CVD events over a mean follow-up of 17.8 months.

Main Results:

  • Both CAC and TAC were significant and independent predictors of incident cardiovascular disease (CVD) events.
  • Patients with severe coronary calcification (CAC score ≥6) had a 3.7 times higher risk of CVD events compared to those with no calcification.
  • Patients with severe aortic calcification (TAC score ≥5) had a 2.7 times higher risk of CVD events compared to those with no calcification.

Conclusions:

  • Subclinical vascular calcification, including coronary and aortic, detected on routine CT scans is a strong predictor of future cardiovascular events.
  • Incidental findings of CAC and TAC on chest CTs hold significant prognostic value in a routine clinical care population.
  • These findings underscore the importance of reporting and considering incidental vascular calcifications for cardiovascular risk assessment.
Abstract

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