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JACC Cardiovasc Imaging. 2016 Feb;9(2):152-9. doi: 10.1016/j.jcmg.2015.06.030. Epub 2016 Jan 6.

Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality.

Author information

1
Department of Orthopaedic Surgery, School of Medicine, University of California, San Diego, California; Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, California.
2
Department of Medicine, School of Medicine, University of California, San Diego, California.
3
Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, California; Department of Medicine, School of Medicine, University of California, San Diego, California; Veterans Affairs San Diego Healthcare System, San Diego, California.
4
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
5
Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, California.
6
Scripps Health, La Jolla, California.
7
Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, California; Department of Medicine, School of Medicine, University of California, San Diego, California; Veterans Affairs San Diego Healthcare System, San Diego, California. Electronic address: joix@ucsd.edu.

Abstract

OBJECTIVES:

The aim of this study was to determine the correlation between coronary artery calcium (CAC) scores on 3 mm electrocardiography (ECG)-gated computed tomography (CT) scans and standard 6 mm chest CT scans, and to compare relative strength of associations of CAC on each scan type with mortality risk.

BACKGROUND:

Coronary artery calcification predicts cardiovascular disease (CVD) and all-cause mortality, and is typically measured on ECG-gated 3 mm CT scans. Patients undergo standard 6 mm chest CTs for various clinical indications much more frequently, but CAC is not usually quantified. To better understand the usefulness of standard chest CTs to quantify CAC, we conducted a case-control study among persons who had both scan types.

METHODS:

Between 2000 and 2003, 4,544 community-living individuals self- or physician-referred for "whole-body" CT scans, had 3 mm ECG-gated CTs and standard 6 mm chest CTs, and were followed for mortality through 2009. In this nested case-control study, we identified 157 deaths and 494 controls frequency matched (1:3) on age and sex. The Agatston method quantified CAC on both scan types. Unconditional logistic regression determined associations with mortality, accounting for CVD risk factors.

RESULTS:

Participants were 68 ± 11 years of age and 63% male. The Spearman correlation of CAC scores between the 2 scan types was 0.93 (p < 0.001); median CAC scores were lower on 6 mm CTs compared to 3 mm CTs (22 vs.104 Agatston units, p < 0.001). Adjusted for traditional CVD risk factors, each standard deviation higher CAC score on 6 mm CTs was associated with 50% higher odds of death (odds ratio: 1.5; 95% confidence interval: 1.2 to 1.9), similar to 50% higher odds on the 3 mm ECG-gated CTs (odds ratio: 1.5; 95% confidence interval: 1.1 to 1.9).

CONCLUSIONS:

CAC scores on standard 6 mm chest CTs are strongly correlated with 3 mm ECG-gated CTs and similarly predict mortality in community-living individuals. Chest CTs performed for other clinical indications may provide an untapped resource to garner CVD risk information without additional radiation exposure or expense.

KEYWORDS:

chest computed tomography; coronary artery calcium; epidemiology; mortality

Comment in

PMID:
26777213
PMCID:
PMC4744104
DOI:
10.1016/j.jcmg.2015.06.030
[Indexed for MEDLINE]
Free PMC Article

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