Unrequested information from routine diagnostic chest CT predicts future cardiovascular events
SourceEuropean Radiology, 21, 8, (2011), pp. 1577-1585
Article / Letter to editor
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SubjectNCEBP 14: Cardiovascular diseases; ONCOL 5: Aetiology, screening and detection
OBJECTIVES: An increase in the number of CT investigations will likely result in a an increase in unrequested information. Clinical relevance of these findings is unknown. This is the first follow-up study to investigate the prognostic relevance of subclinical coronary (CAC) and aortic calcification (TAC) as contained in routine diagnostic chest CT in a clinical care population. METHODS: The follow-up of 10,410 subjects (>40 years) from a multicentre, clinical care-based cohort of patients included 240 fatal to 275 non-fatal cardiovascular disease (CVD) events (mean follow-up 17.8 months). Patients with a history of CVD were excluded. Coronary (0-12) and aortic calcification (0-8) were semi-quantitatively scored. We used Cox proportional-hazard models to compute hazard ratios to predict CVD events. RESULTS: CAC and TAC were significantly and independently predictive of CVD events. Compared with subjects with no calcium, the adjusted risk of a CVD event was 3.7 times higher (95% CI, 2.7-5.2) among patients with severe coronary calcification (CAC score >/=6) and 2.7 times higher (95% CI, 2.0-3.7) among patients with severe aortic calcification (TAC score >/=5). CONCLUSIONS: Subclinical vascular calcification on CT is a strong predictor of incident CVD events in a routine clinical care population.
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