TY - JOUR
T1 - Ordinal scoring of coronary artery calcifications on low-dose CT scans of the chest is predictive of death from cardiovascular disease
AU - Shemesh, Joseph
AU - Henschke, Claudia I.
AU - Shaham, Dorith
AU - Yip, Rowena
AU - Farooqi, Ali O.
AU - Cham, Matthew D.
AU - McCauley, Dorothy I.
AU - Chen, Mildred
AU - Smith, James P.
AU - Libby, Daniel M.
AU - Pasmantier, Mark W.
AU - Yankelevitz, David F.
PY - 2010/11
Y1 - 2010/11
N2 - Purpose: To assess the usefulness of ordinal scoring of the visual assessment of coronary artery calcification (CAC) on low-dose computed tomographic (CT) scans of the chest in the prediction of cardiovascular death. Materials and Methods: All participants consented to low-dose CT screening according to an institutional review board-approved protocol. The amount of CAC was assessed on ungated lowdose CT scans of the chest obtained between June 2000 and December 2005 in a cohort of 8782 smokers aged 40-85 years. The four main coronary arteries were visually scored, and each participant received a CAC score of 0-12. The date and cause of death was obtained by using the National Death Index. Follow-up time (median, 72.3 months; range, 0.3-91.9 months) was calculated as the time between CT and death, loss to follow-up, or December 31, 2007, whichever came first. Logistic regression analysis was used to determine the risk of mortality according to CAC category adjusted for age, pack-years of cigarette smoking, and sex. The same analysis to determine the hazard ratio for survival from cardiac death was performed by using Cox regression analysis. Results: The rate of cardiovascular deaths increased with an increasing CAC score and was 1.2% (43 of 3573 subjects) for a score of 0, 1.8% (66 of 3569 subjects) for a score of 1-3, 5.0% (51 of 1015 subjects) for a score of 4-6, and 5.3% (33 of 625 subjects) for a score of 7-12. With use of subjects with a CAC score of 0 as the reference group, a CAC score of at least 4 was a significant predictor of cardiovascular death (odds ratio [OR], 4.7; 95% confidence interval: 3.3, 6.8; P<.0001); when adjusted for sex, age, and pack-years of smoking, the CAC score remained significant (OR, 2.1; 95% confidence interval: 1.4, 3.1; P =.0002). Conclusion: Visual assessment of CAC on low-dose CT scans provides clinically relevant quantitative information as to cardiovascular death.
AB - Purpose: To assess the usefulness of ordinal scoring of the visual assessment of coronary artery calcification (CAC) on low-dose computed tomographic (CT) scans of the chest in the prediction of cardiovascular death. Materials and Methods: All participants consented to low-dose CT screening according to an institutional review board-approved protocol. The amount of CAC was assessed on ungated lowdose CT scans of the chest obtained between June 2000 and December 2005 in a cohort of 8782 smokers aged 40-85 years. The four main coronary arteries were visually scored, and each participant received a CAC score of 0-12. The date and cause of death was obtained by using the National Death Index. Follow-up time (median, 72.3 months; range, 0.3-91.9 months) was calculated as the time between CT and death, loss to follow-up, or December 31, 2007, whichever came first. Logistic regression analysis was used to determine the risk of mortality according to CAC category adjusted for age, pack-years of cigarette smoking, and sex. The same analysis to determine the hazard ratio for survival from cardiac death was performed by using Cox regression analysis. Results: The rate of cardiovascular deaths increased with an increasing CAC score and was 1.2% (43 of 3573 subjects) for a score of 0, 1.8% (66 of 3569 subjects) for a score of 1-3, 5.0% (51 of 1015 subjects) for a score of 4-6, and 5.3% (33 of 625 subjects) for a score of 7-12. With use of subjects with a CAC score of 0 as the reference group, a CAC score of at least 4 was a significant predictor of cardiovascular death (odds ratio [OR], 4.7; 95% confidence interval: 3.3, 6.8; P<.0001); when adjusted for sex, age, and pack-years of smoking, the CAC score remained significant (OR, 2.1; 95% confidence interval: 1.4, 3.1; P =.0002). Conclusion: Visual assessment of CAC on low-dose CT scans provides clinically relevant quantitative information as to cardiovascular death.
UR - http://www.scopus.com/inward/record.url?scp=77958535835&partnerID=8YFLogxK
U2 - 10.1148/radiol.10100383
DO - 10.1148/radiol.10100383
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:77958535835
SN - 0033-8419
VL - 257
SP - 541
EP - 548
JO - Radiology
JF - Radiology
IS - 2
ER -
