Purpose: The prognostic value of coronary artery calcification (CAC) assessed on non-gated thoracic CT scans has only been explored in population-based studies. We explored the impact of the presence and extension of CAC, as well as of non-coronary atherosclerosis cardiovascular findings (NCACVF) in survival of patients with and without malignancies undergoing clinically indicated non-gated thoracic computed tomography (CT) scans.
Materials And Methods: Between August and December 2012, a total of 1.901 patients aged between 35 and 74 years underwent clinically indicated non-gated, non-enhanced thoracic CT scans and followed for mortality through September 2016.
Results: Three hundred and thirty two (17.5%), 250 (13.2%), and 329 (17.3%) patients showed CAC in 1, 2, and 3 vessels, respectively, and the remaining had no CAC. Two hundred and fifty five (13.4%) patients had evidence of extensive calcification (CACSIS>5). Only 62 (3.3%) had major NCACVF whereas 1635 (86%) had none or minimal NCACVF. After a median follow-up of 3.7 (3.5-3.9) years, 217 (11.4%) deaths occurred. Age [HR 1.03 (95% CI 1.01-1.05), p=0.001], a history of malignancy [HR 8.04 (95% CI 5.95-10.9), p<0.0001], and the NCACVF class [HR 1.79 (95% CI 1.45-2.19), p<0.0001] were identified as independent predictors of death. CACSIS was found an independent predictor of death only among patients without malignancy (HR 1.10 (95% CI 1.02-1.20), p=0.019).
Conclusions: In this study including clinically indicated non-gated standard thoracic CT scans, survival rates were associated to the CAC extension among patients without malignancy, and to the NCACVF class independent from the malignancy status.
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| http://dx.doi.org/10.1016/j.ejrad.2017.05.030 | DOI Listing |
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