Defining The Incidence And Patient Profile Of Incidental Coronary Artery Calcification On Non-cardiac Computed Tomography: An Opportunity To Identify Subclinical Coronary Atherosclerosis

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Conference Proceeding

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Publication Title

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.





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