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Related Concept Videos

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

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The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
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Imaging Studies III: Computed Tomography01:27

Imaging Studies III: Computed Tomography

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DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
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Existing Nongated CT Coronary Calcium Predicts Operative Risk in Patients Undergoing Noncardiac Surgeries (ENCORES).

Daniel Y Choi1, Dena Hayes1, Samuel D Maidman1

  • 1Leon H. Charney Division of Cardiology (D.Y.C., D.H., S.D.M., N.D., J.S.B., R.D., N.R.S.), New York University Grossman School of Medicine, New York, NY.

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Coronary artery calcium scoring from existing nongated chest CT scans can improve cardiovascular risk assessment before noncardiac surgery. This method enhances the prediction of major clinical events, aiding clinical decision-making.

Keywords:
cardiovascular riskcomputed tomographycoronary calciummortality, myocardial infarction, nongatedperioperativerisk index, surgical outcomes

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Area of Science:

  • Cardiology
  • Radiology
  • Health Services Research

Background:

  • Preoperative cardiovascular risk stratification is crucial before noncardiac surgery.
  • ECG-gated CT scans can assess coronary artery calcium, but are not always available.
  • Nongated chest CT scans are common and may offer an alternative for risk assessment.

Purpose of the Study:

  • To evaluate the association between coronary calcium severity from existing nongated chest CT imaging and perioperative major clinical events (MCE).
  • To determine if estimated coronary calcium burden (ECCB) improves risk stratification beyond existing clinical scores.

Main Methods:

  • Retrospective analysis of 2554 adult patients undergoing major noncardiac surgery with prior nongated chest CT.
  • Coronary calcium was graded (0-3 scale) and ECCB (0-9 scale) calculated by blinded physicians.
  • Perioperative MCE defined as death or myocardial infarction within 30 days; compared with Revised Cardiac Risk Index.

Main Results:

  • Higher ECCB correlated with increased perioperative MCE (P<0.001).
  • ECCB addition improved MCE prediction (C-statistic 0.675 to 0.712, P=0.018), with significant net reclassification.
  • ECCB ≥3 was associated with doubled adjusted odds of MCE (aOR, 2.11).

Conclusions:

  • Coronary calcium assessment from existing nongated chest CT scans is feasible.
  • This method enhances preoperative risk stratification for patients undergoing noncardiac surgery.
  • ECCB provides valuable prognostic information for perioperative MCE.