Lima Arthur Santos, de Carvalho Villela Beatriz, Pustilnik Hugo Nunes, Assis Beatriz Dacach, Torreão Jorge Andion, Ritt Luiz Eduardo Fonteles
Escola Bahiana de Medicina e Saúde Pública - Dom João VI Avenue, 275, Brotas, Salvador, Bahia, Brazil.
Escola Bahiana de Medicina e Saúde Pública - Dom João VI Avenue, 275, Brotas, Salvador, Bahia, Brazil.
Clin Imaging. 2025 Oct;126:110595. doi: 10.1016/j.clinimag.2025.110595. Epub 2025 Aug 28.
To evaluate the prognostic value of incidental coronary artery calcium (CACi) identified on routine chest computed tomography (CT) scans in predicting cardiovascular outcomes and its association with statin prescription in asymptomatic individuals.
We searched MEDLINE/PubMed, EMBASE, and Cochrane Library for randomized clinical trials, prospective cohort studies, and retrospective cohort studies. Search terms included combinations of "CT," "routine," "thorax," "coronary," and "calcification. The primary outcomes were cardiovascular mortality and statin initiation in asymptomatic patients with incidental CAC detected on routine chest CT. Statistical analysis was performed using the R software, specifically version 4.3.2.Outcomes included cardiovascular mortality and major adverse cardiovascular events (MACE). Secondary outcomes included statin initiation and medication adherence as reported by each study.
67,127 patients were included from 7 studies, of which 4 were RCT. Follow up ranged from 6 to 135 months and the prevalence of male participants was 86 %. The results indicated a significantly higher likelihood of cardiovascular mortality in the group with incidental CAC presence (OR: 7.38, 95 % CI: 4.10-13.28, p < 0.001). Heterogeneity was considered moderate, with an I of 45 % and a Chi of 7.26.
Incidental coronary artery calcium quantification on routine chest computed tomography is a valuable tool for cardiovascular risk stratification, and the detection of incidental coronary arterial calcium is related with and increased risk of cardiovascular mortality.
评估在常规胸部计算机断层扫描（CT）中发现的偶然冠状动脉钙化（CACi）对预测心血管结局的预后价值及其与无症状个体他汀类药物处方的关联。
我们在MEDLINE/PubMed、EMBASE和Cochrane图书馆中检索了随机临床试验、前瞻性队列研究和回顾性队列研究。检索词包括“CT”、“常规”、“胸部”、“冠状动脉”和“钙化”的组合。主要结局是在常规胸部CT上检测到偶然CAC的无症状患者的心血管死亡率和他汀类药物起始使用情况。使用R软件，具体版本为4.3.2进行统计分析。结局包括心血管死亡率和主要不良心血管事件（MACE）。次要结局包括各研究报告的他汀类药物起始使用情况和药物依从性。
7项研究纳入了67127例患者，其中4项为随机对照试验。随访时间为6至135个月，男性参与者的患病率为86%。结果表明，存在偶然CAC的组心血管死亡的可能性显著更高（OR：7.38，95%CI：4.10-13.28，p<0.001）。异质性被认为是中等的，I²为45%，χ²为7.26。
常规胸部计算机断层扫描上的偶然冠状动脉钙化定量是心血管风险分层的有价值工具，偶然冠状动脉钙化的检测与心血管死亡率增加相关。
