Chen Lu, Vavrenyuk Andrey, Ren Jun Hong, Desai Pankil, Bahgat Joseph, Bernstein Michael A, Ebright Michael I, Gowda Mamatha, Rose Suzanne, Fallahi Arzhang, Stainken Brian, Hsi David H
Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Heart and Vascular Institute, Stamford Hospital, Stamford, CT, United States.
Front Cardiovasc Med. 2021 Jun 16;8:684292. doi: 10.3389/fcvm.2021.684292. eCollection 2021.
Coronary artery calcification (CAC) may provide insight to the patients' coronary artery disease (CAD) risks and influence early intervention. With increasing use of non-gated CT scans in clinical practice, the visual coronary artery scoring system (Weston Method) could quickly provide clinicians with important information of CAC for patient triage and management. We retrospectively studied the available CT imaging data and estimated CAC burden using the Weston method in 493 emergency room or other hospitalized patients. The Weston scores were calculated by the sum of the score for each vessel including the left main, left anterior descending, left circumflex artery and right coronary artery (range 0-12). The primary endpoint was a composite of the major adverse cardiac events (MACEs), including cardiac death, myocardial infarction, stroke, and coronary revascularization. During a median follow-up of 85 months, a total of 25 (5.1%) MACE were recorded and 57 (11.2%) patients died from any causes. Detectable CAC was most common (96%) in the left anterior descending coronary arteries. Multivariable analysis showed that CAC total scores were independent predictors for MACE and all-cause mortality. Receiver operating characteristic analysis showed that CAC total score ≥5 was the optimal cutoff value for predicting MACEs. In the emergency room and hospitalized patients, the semi-quantitation of CAC burden using the Weston score system was related to the long-term cardiovascular outcomes including mortality. Clinicians and radiologists should maximize the value of non-contrast chest CT images by reporting CAC details.
冠状动脉钙化（CAC）可为了解患者的冠状动脉疾病（CAD）风险及影响早期干预提供线索。随着非门控CT扫描在临床实践中的使用增加，视觉冠状动脉评分系统（韦斯顿方法）可为临床医生快速提供有关CAC的重要信息，用于患者分类和管理。我们回顾性研究了493例急诊室或其他住院患者的可用CT成像数据，并使用韦斯顿方法估算了CAC负荷。韦斯顿评分通过计算包括左主干、左前降支、左旋支动脉和右冠状动脉在内的各血管评分之和得出（范围为0 - 12）。主要终点是主要不良心脏事件（MACE）的复合终点，包括心源性死亡、心肌梗死、中风和冠状动脉血运重建。在中位随访85个月期间，共记录了25例（5.1%）MACE，57例（11.2%）患者因任何原因死亡。可检测到的CAC在左前降支冠状动脉中最为常见（96%）。多变量分析表明，CAC总分是MACE和全因死亡率的独立预测因素。受试者工作特征分析表明，CAC总分≥5是预测MACE的最佳临界值。在急诊室和住院患者中，使用韦斯顿评分系统对CAC负荷进行半定量与包括死亡率在内的长期心血管结局相关。临床医生和放射科医生应通过报告CAC详细信息来最大化非增强胸部CT图像的价值。
