Assuta Medical Center, Tel Aviv, affiliated with Ben Gurion University of Negev, Faculty of Medicine, Beer Sheva, Israel.
Faculty of Medicine, Tel-Aviv University, Tel Aviv, Tel Hashomer, 52621, Israel.
Int J Cardiovasc Imaging. 2024 Jan;40(1):177-183. doi: 10.1007/s10554-023-02971-2. Epub 2023 Oct 9.
Thoracic arterial calcifications (TAC) are not routinely reported or quantified in chest CT scans. We aimed to evaluate the association between TAC of the entire thoracic aorta and all-cause mortality (ACM) in patients referred to standard chest CT.
A retrospective analysis of consecutive standard chest CT scans (non-gated, non-contrast) for the quantification of TAC, CAC and aortic valve calcification. TAC was divided into 4 sample-derived categories (TAC 1 = 0, TAC 2 = 1-65, TAC 3 = 66-439 and TAC 4 ≥ 440). Data regarding ACM was retrieved from the health care provider database. Multivariate Cox proportional regression models were used to assess associations between the TAC categories and ACM.
The study cohort included 415 patients (mean age 67 years, 52% male); 107 ACM events were recorded during a median follow-up of 9 years (inter-quartile range: 7.4-10.4). The rate of ACM was 13%, 25%, 32%, 41% according to TAC category (p < 0.001). The highest TAC category (≥ 440) was a strong and independent predictor of ACM [HR = 1.69 (1.13-2.52; 0.01)] in multivariate analysis. Other independent predictors of ACM included age [HR = 1.07 (1.04-1.10; p < 0.001)], male sex [HR = 2.27 (1.49-3.46; 0.001)] and malignancy [HR = 2.21 (1.49-3.23; < 0.001)].
Severe TAC (≥ 440) was found to be an independent predictor of ACM. Thus, we suggest that documenting and quantifying TAC should be routinely incorporated into standard chest CT reports.
在胸部 CT 扫描中，通常不会报告或量化胸主动脉钙化（TAC）。我们旨在评估在接受标准胸部 CT 检查的患者中，整个胸主动脉 TAC 与全因死亡率（ACM）之间的关联。
对连续的标准胸部 CT 扫描（非门控、非对比）进行回顾性分析，以量化 TAC、CAC 和主动脉瓣钙化。TAC 分为 4 个样本衍生类别（TAC 1=0，TAC 2=1-65，TAC 3=66-439 和 TAC 4≥440）。从医疗服务提供商数据库中检索 ACM 数据。使用多变量 Cox 比例风险回归模型评估 TAC 类别与 ACM 之间的关联。
该研究队列包括 415 名患者（平均年龄 67 岁，52%为男性）；在中位数为 9 年（四分位距：7.4-10.4）的随访期间记录了 107 例 ACM 事件。根据 TAC 类别，ACM 的发生率分别为 13%、25%、32%、41%（p<0.001）。在多变量分析中，TAC 最高类别（≥440）是 ACM 的一个强有力的独立预测因子[HR=1.69（1.13-2.52；0.01）]。ACM 的其他独立预测因子包括年龄[HR=1.07（1.04-1.10；p<0.001）]、男性性别[HR=2.27（1.49-3.46；0.001）]和恶性肿瘤[HR=2.21（1.49-3.23；<0.001）]。
严重的 TAC（≥440）被发现是 ACM 的独立预测因子。因此，我们建议在标准胸部 CT 报告中应常规记录和量化 TAC。
