Chest CT Scans Predict Cardiovascular Event Risk
A new study finds that, in addition to being used for diagnostic purposes, incidental chest computed tomography (CT) findings can help identify individuals at risk for future heart attacks and other cardiovascular events.
Study authors from the University Medical Center Utrecht, in Utrecht, the Netherlands, note that patients at high risk for cardiovascular events are currently identified through risk stratification tools based on conventional risk factors such as age, gender, blood pressure, cholesterol levels, diabetes, smoking status, or other factors thought to be related to heart disease. Their research, they say, provides “a different approach for cardiovascular disease risk prediction strictly based on information readily available to the radiologist.”
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In a retrospective study, researcher Pushpa M. Jairam, MD, PhD, and colleagues from the University Medical Center Utrecht analyzed follow-up data from 10,410 patients who had undergone diagnostic chest CT for non-cardiovascular indications. Among these patients, 1,148 cardiovascular events occurred during a mean follow-up period of 3.7 years.
CT scans from these patients, and from a random sampling of 10 percent of the other participants, were visually graded for several cardiovascular findings. The final prediction model included age, gender, CT indication, left anterior descending coronary artery calcifications, mitral valve calcifications, descending aorta calcifications, and cardiac diameter.
According to the authors, this model was found to accurately place individuals into clinically relevant risk categories, and the results demonstrated that radiologic information “may complement standard clinical strategies in cardiovascular risk screening, and may improve diagnosis and treatment in eligible patients.”
Dr. Jairam points out that the risk score the authors developed is based on incidental CT findings, adding that most diagnostic CT scans are ordered by medical specialists such as pulmonologists or surgeons, for example, rather than primary care physicians.
However, “I envision that when the developed risk score will be used in regular practice, there will be a role for general practitioners, says Jairam.
“When radiologists calculate the score for patients who underwent a chest CT, the results should be sent to the general practitioner, who can provide cardiovascular management—assessment and treatment of risk factors if needed—in subjects with a high risk of CVD.”
—Mark McGraw
Reference
Jairam P, Gondrie M, et al. Incidental Imaging Findings from Routine Chest CT Used to Identify Subjects at High Risk of Future Cardiovascular Events. Radiology. 2014.