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Predictive factors of thoracic aortic calcification in patients candidate for cardiac surgery
Amin Bagheri1,2, Shapour Shirani1, Arash Jalali1
1Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Severe thoracic aortic calcification (TAC) in cardiac surgery patients is linked to poor outcomes. Peripheral vascular disease, opium addiction, diabetes, and age predict TAC, suggesting targeted screening is needed.
Area of Science:
- Cardiovascular Imaging and Intervention
- Thoracic Surgery
- Vascular Disease
Background:
- Severe thoracic aortic calcification (TAC) is associated with adverse outcomes in cardiac surgery patients.
- The link between cardiovascular risk factors and aortic plaque burden is not well understood.
- Identifying predictors of TAC is crucial for risk stratification.
Purpose of the Study:
- To determine the predictive factors of severe thoracic aortic calcification (TAC) in patients undergoing cardiac surgery.
- To investigate the association between cardiovascular risk factors and TAC.
- To establish a foundation for a TAC risk score.
Main Methods:
- Retrospective analysis of 556 patients who underwent pre-operative thoracic CT scans.
- Categorization into severe TAC (TACS ≥ 400 mm²) and non-severe TAC groups.
- Stepwise multivariable logistic regression to identify predictors of severe TAC.
Main Results:
- Severe TAC (TACS ≥ 400) was more prevalent in older patients with higher rates of diabetes mellitus, dyslipidemia, hypertension, opium addiction, and peripheral vascular disease (PVD).
- Multivariable analysis identified PVD (OR=2.86), opium addiction, diabetes, and age as independent predictors of severe TAC.
- Significant differences in mean age and frequency of comorbidities were observed between severe and non-severe TAC groups.
Conclusions:
- Thoracic CT screening is recommended for patients with risk factors like older age, diabetes, opium addiction, and PVD prior to cardiac surgery.
- These findings highlight key predictors of TAC and support the development of a risk stratification tool.
- Further research is warranted to develop and validate a comprehensive risk score for TAC.
Background:
The presence of the severe thoracic aortic calcification (TAC) in cardiac surgery patients is associated with adverse post-operative outcome. However, the relationship between cardiovascular risk factors and aortic plaque burden remains unknown. The objective of this study was to determine the predictive factors of TAC in patients candidate for cardiac surgery.
Methods:
Patients who underwent thoracic CT scan prior to cardiac surgery between August 2020 to April 2021 were included. Of 556 patients, 209 (36.7%) had a thoracic aortic calcium score (TACS) ≥ 400 mm [3] and were compare with the remaining patients. Predictors of severe TAC were assessed through stepwise multivariable logistic regression analysis.
Results:
The patients with TACS ≥ 400 had a higher mean age (67.3 ± 7.1 vs. 55.7 ± 10.6; p < 0.001) with a higher frequency of diabetes mellitus (40.7% vs. 30.8%; p = 0.018), dyslipidemia (49.8% vs. 38.6%; p = 0.010), hypertension (60.8% vs. 44.7%; p < 0.001), opium addiction (18.2% vs. 11.2%; p = 0.023), peripheral vascular disease (PVD) (7.7% vs. 2.3%; p = 0.005) as compared with TACS < 400. The multiple determinants of TAC were PVD (OR = 2.86) followed by opium addiction, diabetes and age.
Conclusions:
Thoracic CT scan prior to cardiac surgery for patients with older age, diabetes, opium addiction and PVD is recommended. Our study could serve as a foundation for future research endeavors aimed at establishing a risk score for TAC.
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