April 28, 2017PLoS ONEOpen Access

Assessment of coronary artery calcium by chest CT compared with EKG-gated cardiac CT in the multicenter AIDS cohort study

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Subclinical coronary artery disease in HIV (n=108). Intervention: Non-EKG-gated chest CT (Weston score) vs. EKG-gated cardiac CT (Agatston score). Primary outcome: Agreement between category of Weston and Agatston scores (κw = 0.77, p=<0.001).

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Key result

Non-EKG-gated chest CT (Weston score) showed excellent correlation (rs = 0.92) and agreement (κw = 0.77) with EKG-gated cardiac CT (Agatston score) for assessing coronary artery calcium.

Why the study?

Does non-EKG-gated chest CT with Weston scoring provide a useful surrogate for EKG-gated cardiac CT with Agatston scoring for assessing coronary artery calcium in men with and without HIV?

Population

108 men enrolled in the Multicenter AIDS Cohort Study, median age 55.2 years, 57.4% HIV seropositive.

Comparison

Assessment of coronary artery calcium using… vs EKG-gated cardiac CT imaging using Agatston…

Design

Cohort

Authors

DCDivay ChandraUniversity of Pittsburgh AGAman GuptaGovernment Medical College JLJoseph K. LeaderUniversity of Pittsburgh

Discussion

Member takes

Implication

Suggests non-gated chest CT may serve as a viable opportunistic screening tool for coronary calcium;.

Study Design

Type

Cross-Sectional (n=108)

Blinding

Single-blind

Multicenter

Yes

Structured PICO

Does non-EKG-gated chest CT with Weston scoring provide a useful surrogate for EKG-gated cardiac CT with Agatston scoring for assessing coronary artery calcium in men with and without HIV?

Population

108 men (57.4% HIV-positive) enrolled in the Multicenter AIDS Cohort Study who underwent both EKG-gated cardiac CT and non-EKG-gated chest CT within two years of each other.

Exposure

Assessment of coronary artery calcium (CAC) using non-EKG-gated chest CT and the Weston scoring system.

Comparator

EKG-gated cardiac CT imaging using Agatston scoring.

Outcome

Correlation and agreement between Weston and Agatston scores.surrogate

Main Result

Effect estimate: κw = 0.77

p-value: p=<0.001

Non-EKG-gated chest CT using the Weston score shows excellent correlation and agreement with EKG-gated cardiac CT Agatston scoring for assessing coronary artery calcium, offering a viable alternative when gated CT is not feasible.

Limitations

Weston scoring is performed visually and may be more subjective than Agatston scores
EKG-gated and non-EKG-gated CT scans were not performed on the same day (within two years of each other)
Study was limited to men and may not be generalizable to women
CT scans used for Weston scoring were acquired at modest radiation dose and may not be generalizable to other CT protocols
Lack of data demonstrating that Weston scores predict mortality or cardiac events in those with HIV
Unclear if Weston scores are sensitive to longitudinal change compared with Agatston scores

Cite This Study

Chandra et al. (2017) conducted a cross-sectional in Subclinical coronary artery disease in HIV (n=108). Non-EKG-gated chest CT (Weston score) vs. EKG-gated cardiac CT (Agatston score) was evaluated on Agreement between category of Weston and Agatston scores (κw = 0.77, p=<0.001). Non-EKG-gated chest CT (Weston score) showed excellent correlation (rs = 0.92) and agreement (κw = 0.77) with EKG-gated cardiac CT (Agatston score) for assessing coronary artery calcium.

synapsesocial.com/papers/6a81aaeccb8186709ca1ecb2 https://doi.org/10.1371/journal.pone.0176557

Topics

Coronary CT angiography

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April 28, 2017PLoS ONEOpen Access

Assessment of coronary artery calcium by chest CT compared with EKG-gated cardiac CT in the multicenter AIDS cohort study

View Full Paper

Ask AI

Bookmark

Key result

Non-EKG-gated chest CT (Weston score) showed excellent correlation (rs = 0.92) and agreement (κw = 0.77) with EKG-gated cardiac CT (Agatston score) for assessing coronary artery calcium.

Why the study?

Does non-EKG-gated chest CT with Weston scoring provide a useful surrogate for EKG-gated cardiac CT with Agatston scoring for assessing coronary artery calcium in men with and without HIV?

Population

108 men enrolled in the Multicenter AIDS Cohort Study, median age 55.2 years, 57.4% HIV seropositive.

Comparison

Assessment of coronary artery calcium using… vs EKG-gated cardiac CT imaging using Agatston…

Design

Cohort

Authors

DCDivay ChandraUniversity of Pittsburgh AGAman GuptaGovernment Medical College JLJoseph K. LeaderUniversity of Pittsburgh

Discussion

Member takes

Implication

Suggests non-gated chest CT may serve as a viable opportunistic screening tool for coronary calcium;.

Study Design

Type

Cross-Sectional (n=108)

Blinding

Single-blind

Multicenter

Yes

Structured PICO

Does non-EKG-gated chest CT with Weston scoring provide a useful surrogate for EKG-gated cardiac CT with Agatston scoring for assessing coronary artery calcium in men with and without HIV?

Population

108 men (57.4% HIV-positive) enrolled in the Multicenter AIDS Cohort Study who underwent both EKG-gated cardiac CT and non-EKG-gated chest CT within two years of each other.

Exposure

Assessment of coronary artery calcium (CAC) using non-EKG-gated chest CT and the Weston scoring system.

Comparator

EKG-gated cardiac CT imaging using Agatston scoring.

Outcome

Correlation and agreement between Weston and Agatston scores.surrogate

Main Result

Effect estimate: κw = 0.77

p-value: p=<0.001

Limitations

Weston scoring is performed visually and may be more subjective than Agatston scores
EKG-gated and non-EKG-gated CT scans were not performed on the same day (within two years of each other)
Study was limited to men and may not be generalizable to women
CT scans used for Weston scoring were acquired at modest radiation dose and may not be generalizable to other CT protocols
Lack of data demonstrating that Weston scores predict mortality or cardiac events in those with HIV
Unclear if Weston scores are sensitive to longitudinal change compared with Agatston scores

Cite This Study

synapsesocial.com/papers/6a81aaeccb8186709ca1ecb2 https://doi.org/10.1371/journal.pone.0176557

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Coronary CT angiography

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