Incidentally identified coronary artery calcium on chest CT was independently associated with increased risk of major adverse cardiac events in hospital inpatients (adjusted HR 2.4; 95% CI 1.3-4.3).
Cohort (n=280)
No
Does incidentally identified coronary artery calcium on non-contrast CT scan of the chest predict major adverse cardiac events in hospital inpatients?
Incidentally identified coronary artery calcium on non-contrast chest CT in hospital inpatients is an independent predictor of MACE, highlighting an opportunity for aggressive risk factor modification.
Hazard Ratio: 2.4 (95% CI 1.3–4.3)
BACKGROUND: Coronary artery calcium (CAC) identified on non-gated CT scan of the chest is predictive of major adverse cardiac events (MACE) in multiple studies with guidelines therefore recommending the routine reporting of incidental CAC. These studies have been limited however to the outpatient setting. We aimed to determine the prognostic utility of incidentally identified CAC on CT scan of the chest among hospital inpatients. METHODS AND RESULTS: Consecutive patients (n=740) referred for inpatient non-contrast CT scan of the chest at a tertiary referral hospital (January 2011 to March 2017) were included (n=280) if they had no known history of coronary artery disease, active malignancy or died within 30 days of admission. Scans were assessed for the presence of CAC by visual assessment and quantified by Agatston scoring. Median age was 69 years (IQR: 54-82) and 51% were male with a median CAC score of 7 (IQR 0-205). MACE occurred in 140 (50%) patients at 3.5 years median follow-up including 98 deaths. Half of all events occurred within 18 months. Visible CAC was associated with increased MACE (HR) 6.0 (95% CI: 3.7 to 9.7) compared with patients with no visible CAC. This finding persisted after adjusting for cardiovascular risk factors HR 2.4 (95% CI: 1.3 to 4.3) and with both absolute CAC score and CAC score ≥50th percentile. CONCLUSION: Incidental CAC identified on CT scan of the chest among hospital inpatients provides prognostic information that is independent of cardiovascular risk factors. These patients may benefit from aggressive risk factor modification given the high event rate in the short term.
Yu et al. (Fri,) conducted a cohort in Hospital inpatients referred for non-contrast CT scan of the chest (n=280). Incidentally identified coronary artery calcium vs. No visible coronary artery calcium was evaluated on Major adverse cardiac events (MACE) (HR 2.4, 95% CI 1.3-4.3). Incidentally identified coronary artery calcium on chest CT was independently associated with increased risk of major adverse cardiac events in hospital inpatients (adjusted HR 2.4; 95% CI 1.3-4.3).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: