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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
CT-Detected Arterial Calcification and Ischemic Cardiovascular Risk Assessment in Patients with Upper Urinary Tract
Zhan Qu1, Wenbo Yang2,3, Shijun Liu2,3
1Department of Urology, Capital Medical University Electric Power Teaching Hospital (State Grid Corporation of China Beijing Electric Power Hospital), Beijing, 100073, People's Republic of China.
Insights
Arterial calcification (AC) in patients with upper urinary tract calculi (UUTC) is linked to a higher risk of ischemic cardiovascular diseases (ICVD). Early detection of AC in UUTC patients is crucial for cardiovascular risk assessment.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Radiology
Background:
- Arterial calcification (AC) is commonly detected in computed tomography (CT) scans of patients with upper urinary tract calculi (UUTC).
- The association between AC in UUTC patients and the risk of ischemic cardiovascular diseases (ICVD) requires further investigation.
Purpose of the Study:
- To investigate the relationship between CT-detected AC in UUTC patients and the risk of developing ICVD.
- To identify independent risk factors for AC in UUTC patients and develop a risk assessment tool.
Main Methods:
- Retrospective case-control study involving 596 patients (396 UUTC patients, 200 controls).
- Analysis of bone mineral density (BMD) of L1 vertebra, arterial calcification, and 10-year ICVD risk scores.
- Multivariate logistic regression and development of a validated AC risk scoring system.
Main Results:
- AC prevalence was significantly higher in the UUTC group (71.7%) compared to controls (63.5%).
- UUTC patients had lower L1 vertebra BMD and elevated 10-year ICVD risk scores.
- Low L1 BMD (<160 HU) was an independent risk factor for AC; AC presence increased high-risk ICVD classification by 13.7-fold.
Conclusions:
- Arterial calcification and the risk of ICVD are significantly associated with UUTC.
- CT-based AC assessment integrated with UUTC data can aid in ICVD risk stratification.
- Cardiovascular surveillance is recommended for individuals with UUTC.
Objective:
Arterial calcification (AC) is frequently observed in computed tomography (CT) scans of patients with upper urinary tract calculi (UUTC). This study aimed to investigate the relationship between AC detected by CT in UUTC patients and the risk of ischemic cardiovascular diseases (ICVD).
Methods:
In this retrospective case-control study, clinical data of 596 patients were collected. Bone mineral density (BMD) of L1 vertebra and calcification of major/medium arteries were analyzed. Differences in clinical data, CT images and 10-year ICVD risk scores were compared between groups. Univariate analysis and multivariate logistic regression identified independent risk factors for AC in UUTC patients. A scoring system to assess concurrent AC risk in UUTC patients was developed and validated.
Results:
A total of 396 UUTC patients and 200 controls were included. AC prevalence was higher in UUTC group (71.7% vs 63.5%, P = 0.041), remained valid after controlling for specific confounding factors. UUTC patients exhibited lower BMD of L1 vertebra. Their 10-year ICVD risk scores were elevated (male: OR = 2.450, 95% CI = 1.262-4.758, P = 0.007; female: OR = 4.340, 95% CI = 2.203-8.550, P < 0.001). Multivariate analysis confirmed L1 vertebra BMD < 160 Hounsfield units (OR = 3.660, 95% CI = 2.107-6.358, P < 0.001) as an independent AC risk factor. The presence of AC was associated with a 13.7-fold increased odds of high-risk group classification (OR = 13.689, 95% CI = 8.021-23.346, P < 0.001).
Conclusion:
AC and the risk of ICVD are associated with UUTC. Our study establishes an innovative integration of UUTC with CT-based AC assessment and ICVD risk stratification, highlighting the need for cardiovascular surveillance in UUTC-affected individuals.
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