Hedayati Goudarzi Mohammad Taghi, Abrotan Saeed, Ziaie Naghmeh, Amin Kamyar, Saravi Mehrdad, Jalali Seyed Farzad, Pourkia Roghayeh, Jafaripour Iraj, Moradi Amir, Kargar-Soleimanabad Saeed, Saffar Homina
Department of Cardiology, School of Medicine, Rouhani Hospital, Babol University of Medical Sciences, Babol.
Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz.
Ann Med Surg (Lond). 2024 Apr 4;86(6):3227-3232. doi: 10.1097/MS9.0000000000001661. eCollection 2024 Jun.
Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined.
To investigate the association between CAC score and in-hospital mortality of COVID-19 patients.
This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes.
The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70-10.33, value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13-1.53, value < 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47-2.77, value < 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79-18.29, value: 0.003), and history of respiratory diseases (95% CI: 2.18-40, value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 ( value < 0.001).
Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.
冠状动脉钙化（CAC）已被确认为主要不良心血管事件的独立危险因素。然而，CAC对新型冠状病毒肺炎（COVID-19）患者住院死亡率和不良临床结局的影响尚未确定。
探讨CAC评分与COVID-19患者住院死亡率之间的关联。
本回顾性队列研究在伊朗北部城市巴博勒医科大学的三级医院开展，纳入了2021年3月至10月期间551例确诊的COVID-19患者，这些患者具有明确的死亡或出院临床结局。系统收集了人口统计学和临床数据，以及入院时的胸部计算机断层扫描（CT）结果和CAC评分。该研究采用逻辑回归分析和Kaplan-Meier曲线来探讨CAC评分与住院死亡及不良临床结局之间的关联。
平均年龄为60.05±12.8岁。在幸存者和非幸存者之间，观察到在CAC评分、年龄、高血压病史、高脂血症、心血管疾病和呼吸系统疾病方面存在显著差异；然而，未发现性别存在差异。此外，在多变量分析中，CAC评分大于或等于400[比值比（OR）：4.2，95%置信区间（CI）：1.70-10.33，P值：0.002]、住院时间（OR：1.31，95%CI：1.13-1.53，P值<0.001）、重症监护病房（ICU）住院时长（OR：2.02，95%CI：1.47-2.77，P值<0.001）、入院时COVID-19的严重或危重症程度（95%CI：1.79-18.29，P值：0.003）以及呼吸系统疾病史（95%CI：2.18-40，P值：0.003）与住院死亡率较高的几率相关。对数秩检验还显示，CAC评分大于或等于400的患者与CAC评分小于400的患者之间在入院至死亡时间方面存在显著差异（P值<0.001）。
升高的CAC评分是确诊COVID-19患者住院死亡率和不良临床结果的关键危险因素。这一发现强调了对高CAC评分个体进行密切监测的必要性。
