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Updated: Jun 1, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Coronary Artery Calcification on Chest Computed Tomography as a Predictor of Cardiovascular Adverse Events in
Mayuko Watase1,2, Yusuke Shiraishi3, Shotaro Chubachi1
1Division of Pulmonary Medicine, Department of Internal Medicine, Keio University School of Medicine.
Insights
Severe coronary artery calcification (CAC) in COVID-19 patients independently predicts cardiovascular complications. Chest CT scans can identify high-risk individuals for better cardiovascular event prediction.
Area of Science:
- Cardiology
- Radiology
- Infectious Diseases
Background:
- Coronary artery calcification (CAC) on chest CT predicts cardiovascular events in asymptomatic individuals.
- Limited data exists on CAC's predictive value for COVID-19 cardiovascular complications.
Purpose of the Study:
- To investigate the impact of CAC on cardiovascular complications in a large cohort of COVID-19 patients.
Main Methods:
- Multicenter retrospective cohort study using the Japan COVID-19 Task Force database.
- 1,109 COVID-19 patients analyzed, stratified by CAC severity (no, moderate, severe) using the Agatston score.
- Primary outcome: cardiovascular complications; Secondary outcome: critical outcomes.
Main Results:
- Severe CAC group showed a higher rate of cardiovascular complications.
- Severe CAC was independently associated with cardiovascular complications, but not critical outcomes.
- In patients without comorbidities, severe CAC significantly correlated with cardiovascular complications.
Conclusions:
- Severe CAC in COVID-19 patients is linked to increased cardiovascular complications.
- Chest CT findings, including CAC, are crucial for risk prediction in COVID-19 patients.
- Non-electrocardiogram-gated CT for CAC measurement aids in patient risk stratification.
Background:
Coronary artery calcification (CAC) detected through chest computed tomography (CT) strongly predicts cardiovascular events in asymptomatic individuals undergoing primary prevention. Few studies with limited sample sizes have investigated the predictive value of CAC for cardiovascular complications in COVID-19. This study examined the impact of CAC on cardiovascular complications using a large-scale COVID-19 database.
Methods And Results:
This multicenter retrospective cohort study used data from the Japan COVID-19 Task Force database. After exclusion based on missing information, 1,109 patients with COVID-19 were included. The Agatston score was used to evaluate CAC, dividing the population into 3 groups based on calcification degree (no, moderate, and severe CAC). The primary outcome was cardiovascular complications; the secondary outcome was critical outcomes. The severe CAC group had a higher rate of cardiovascular complications than the other groups. Multivariable analysis, considering COVID-19 severity factors, identified severe CAC as independently associated with cardiovascular complications but not with critical outcomes. Subgroup analysis revealed that, in patients without hypertension, diabetes, cardiovascular disease, or chronic kidney disease, severe CAC was significantly correlated with cardiovascular complications, whereas this association was not observed in patients with these underlying conditions.
Conclusions:
Patients with COVID-19 and severe CAC had increased cardiovascular complications, and identifying cardiovascular and pulmonary findings on chest CT is essential. Measuring CAC via non-electrocardiogram-gated CT helps predict patient risk.
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