Defining The Incidence And Patient Profile Of Incidental Coronary Artery Calcification On Non-cardiac Computed Tomography: An Opportunity To Identify Subclinical Coronary Atherosclerosis
Vishwanath R, Iordanou J, Singh V, Gorgis S, Papukhyan H, Hana A, and Ananthasubramaniam K. Defining The Incidence And Patient Profile Of Incidental Coronary Artery Calcification On Non-cardiac Computed Tomography: An Opportunity To Identify Subclinical Coronary Atherosclerosis. Journal of Cardiovascular Computed Tomography 2020; 14(3):S54.
Journal of Cardiovascular Computed Tomography
Introduction: Coronary artery calcification (CAC) is an independent predictor of cardiac events. The increased use of thoracic Computed Tomography (CT) has made coronary calcification a common incidental finding, although the frequency remains unknown. We aimed to identify the incidence of CAC found on routine non-ECG gated CT scans, and risk factors associated with these findings.
Methods: A systematic review was conducted through literature search using predetermined search criteria. Applicable studies were screened by 3 investigators for eligibility. Data regarding indication for CT imaging, incidence of CAC, and cardiovascular risk factors was collected.
Results: A total of 3,850 study subjects were included for review. CAC was found in 1,231 patients, with an incidence rate of 32%. Indications for CT imaging were; 33% lung cancer screening, 16% for intrapulmonary pathology, 13% for pulmonary thromboembolism, 33% for miscellaneous reasons. In patients with CAC, the average age was 59.4 years old, and 77.9% were male. Hypertension was present in 45.5% of patients, diabetes mellitus was recorded in 25%, and smoking was found in 41.5% of patients.
Conclusions: In this systematic review of 6 studies, incidental CAC on non-ECG gated CT scans was found in 32% of patients. The majority of these patients were identified to have major risk factors for coronary artery disease. Incidental CAC should be routinely reported on non-ECG gated CT scans, as it presents opportunity for detecting subclinical atherosclerosis which can impact patient counselling and medical management.