A new study published in the journal Radiology indicates that incidental chest CT findings may help identify patients at risk for a cardiovascular event.
Patients susceptible to heart disease are currently identified through a number of risk factors, including age, gender, blood pressure, cholesterol levels, diabetes, smoking status, and others. However, many patients display no conventional risk factors, while visible risk factors may go undetected or undiagnosed in other patients.
“Extensive literature has clearly documented the uncertainty of prediction models based on conventional risk factors,” said Pushpa M. Jairam, MD, PhD, from the University Medical Center Utrecht in the Netherlands. “With this study, we address to some extent the need for a shift in cardiovascular risk assessment from conventional risk factors to direct measures of subclinical atherosclerosis.”
The retrospective study evaluated follow-up data from 10,410 patients who underwent diagnostic chest CT for non-cardiovascular indications. During a mean follow-up period of 3.7 years, 1,148 cardiovascular events occurred among the study’s population.
Researchers evaluated CT scans from the affected patients against random sampling of 10% of the remaining patients in the group, visually assessing the scans for cardiovascular findings. They then built a predictive model that included age, gender, CT indication, left anterior descending coronary artery calcifications, mitral valve calcifications, descending aorta calcifications, and cardiac diameter.
The model was found to have accurately placed individuals into clinically relevant risk categories, though Jairam warns that a multicenter trial is needed to validate the findings.
“Incidental Imaging Findings from Routine Chest CT Used to Identify Subjects at High Risk of Future Cardiovascular Events.” Collaborating with Dr. Jairam were Martijn J.A. Gondrie, MD, PhD, Diederick E. Grobbee, MD, PhD, Willem P. Th. M. Mali, MD, PhD, Peter C. A. Jacobs, MD, PhD, and Yolanda van der Graaf, MD, PhD.