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Updated: Jun 24, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective
Mohammad Taghi Hedayati Goudarzi1, Saeed Abrotan1, Naghmeh Ziaie1
1Department of Cardiology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol.
Insights
Elevated coronary artery calcification (CAC) scores are linked to higher in-hospital mortality in COVID-19 patients. This highlights the importance of monitoring individuals with high CAC scores for adverse outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- Coronary artery calcification (CAC) is a known risk factor for cardiovascular events.
- The impact of CAC on COVID-19 patient mortality remains unclear.
Purpose of the Study:
- To investigate the association between CAC score and in-hospital mortality in COVID-19 patients.
Main Methods:
- Retrospective cohort study of 551 COVID-19 patients.
- Data collected included demographics, clinical information, chest CT findings, and CAC score.
- Logistic regression and Kaplan-Meier analysis were used.
Main Results:
- A CAC score >= 400 was associated with increased in-hospital mortality (OR: 4.2).
- Hospitalization time, ICU stay, severe/critical COVID-19, and respiratory disease history also predicted mortality.
- Patients with CAC score >= 400 had significantly shorter survival times.
Conclusions:
- Elevated CAC score is a significant risk factor for in-hospital mortality in COVID-19 patients.
- High CAC scores indicate a need for closer patient monitoring.
- CAC assessment may aid in risk stratification for COVID-19 patients.
Background:
Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined.
Objective:
To investigate the association between CAC score and in-hospital mortality of COVID-19 patients.
Method:
This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes.
Results:
The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70-10.33, P value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13-1.53, P value < 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47-2.77, P value < 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79-18.29, P value: 0.003), and history of respiratory diseases (95% CI: 2.18-40, P value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 (P value < 0.001).
Conclusion:
Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.
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