Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Eur Radiol. 2011 Aug;21(8):1577-85. doi: 10.1007/s00330-011-2112-8. Epub 2011 May 21.
An increase in the number of CT investigations will likely result in a an increase in unrequested information. Clinical relevance of these findings is unknown. This is the first follow-up study to investigate the prognostic relevance of subclinical coronary (CAC) and aortic calcification (TAC) as contained in routine diagnostic chest CT in a clinical care population.
The follow-up of 10,410 subjects (>40 years) from a multicentre, clinical care-based cohort of patients included 240 fatal to 275 non-fatal cardiovascular disease (CVD) events (mean follow-up 17.8 months). Patients with a history of CVD were excluded. Coronary (0-12) and aortic calcification (0-8) were semi-quantitatively scored. We used Cox proportional-hazard models to compute hazard ratios to predict CVD events.
CAC and TAC were significantly and independently predictive of CVD events. Compared with subjects with no calcium, the adjusted risk of a CVD event was 3.7 times higher (95% CI, 2.7-5.2) among patients with severe coronary calcification (CAC score ≥6) and 2.7 times higher (95% CI, 2.0-3.7) among patients with severe aortic calcification (TAC score ≥5).
Subclinical vascular calcification on CT is a strong predictor of incident CVD events in a routine clinical care population.
CT 检查数量的增加可能会导致未请求信息的增加。这些发现的临床相关性尚不清楚。这是第一项随访研究，旨在调查常规诊断性胸部 CT 中包含的亚临床冠状动脉（CAC）和主动脉钙化（TAC）对临床护理人群中心血管疾病（CVD）预后的相关性。
对来自多中心临床护理患者队列的 10410 名（>40 岁）受试者进行随访，包括 240 例致命性和 275 例非致命性 CVD 事件（平均随访时间 17.8 个月）。排除有 CVD 病史的患者。对冠状动脉（0-12）和主动脉钙化（0-8）进行半定量评分。我们使用 Cox 比例风险模型计算危险比以预测 CVD 事件。
CAC 和 TAC 与 CVD 事件显著且独立相关。与无钙患者相比，严重冠状动脉钙化（CAC 评分≥6）患者的 CVD 事件调整风险高 3.7 倍（95%CI，2.7-5.2），严重主动脉钙化（TAC 评分≥5）患者的 CVD 事件调整风险高 2.7 倍（95%CI，2.0-3.7）。
CT 上的亚临床血管钙化是常规临床护理人群中发生 CVD 事件的有力预测指标。
