Comparison of ordinal versus Agatston coronary calcification scoring for cardiovascular disease mortality in community-living individuals

Blair, Katherine J.; Allison, Matthew A.; Morgan, Cindy; Wassel, Christina L.; Rifkin, Dena E.; Wright, C. Michael; Criqui, Michael H.; Ix, Joachim H.

doi:10.1007/s10554-014-0392-1

Cited by 31 publications

(17 citation statements)

References 13 publications

(17 reference statements)

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“…(22) Jacobs and colleagues demonstrated that, by using simple visual grading to measure CAC on standard chest CT, CAC was strongly associated with future CVD events. (23) Thus, by simple visual grading system evaluated by others,(23, 24) or by the Agatston method used here, the detection of CAC on standard chest CT has prognostic implications. As it has important implications for preventive care, we believe it should be systematically reported.…”

Section: Discussionmentioning

confidence: 84%

Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality

Hughes‐Austin

Domínguez

Allison

et al. 2016

JACC: Cardiovascular Imaging

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STRUCTURED ABSTRACT Objectives We aimed to determine the correlation between coronary artery calcium (CAC) scores on 3mm ECG-gated computed tomography (CT) scans and standard 6mm chest CT scans, and to compare relative strength of associations of CAC on each scan type with mortality risk. Background Coronary artery calcification predicts cardiovascular disease (CVD) and all-cause mortality, and is typically measured on ECG-gated 3mm CT scans. Patients undergo standard 6mm chest CTs for various clinical indications much more frequently, but CAC is not usually quantified. To better understand the usefulness of standard chest CTs to quantify CAC, we conducted a case-control study among persons who had both scan types. Methods Between 2000–03, 4,544 community-living individuals self- or physician-referred for “whole body” CT scans, had 3mm ECG-gated CTs and standard 6mm chest CTs, and were followed for mortality through 2009. In this nested case-control study, we identified 157 deaths and 494 controls frequency matched (1:3) on age and gender. The Agatston method quantified CAC on both scan types. Unconditional logistic regression determined associations with mortality, accounting for CVD risk factors. Results Participants were 68±11 years old and 63% male. The Spearman correlation of CAC scores between the two scan types was 0.93 (p<0.001); median CAC scores were lower on 6mm CTs compared to 3mm CTs (22 vs.104 Agatston units, p<0.001). Adjusted for traditional CVD risk factors, each SD higher CAC score on 6mm CTs was associated with 50% higher odds of death (OR=1.5; 1.2–1.9), similar to 50% higher odds on the 3mm ECG-gated CTs (OR=1.5, 1.1–1.9). Conclusions CAC scores on standard 6mm chest CTs are strongly correlated with 3mm ECG-gated CTs and similarly predict mortality in community-living individuals. Chest CTs performed for other clinical indications may provide an untapped resource to garner CVD risk information without additional radiation exposure or expense.

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Section: Discussionmentioning

confidence: 84%

Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality

Hughes‐Austin

Domínguez

Allison

et al. 2016

JACC: Cardiovascular Imaging

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105

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“…[60] 4544 community-living individuals undergoing non-ECG synchronized CT were followed for CVD death over 9 years follow-up. A simple ordinal calcium 'score' based on standard non-ECG synchronized chest CT was evaluated.…”

Section: Computed Tomography Componentmentioning

confidence: 99%

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Bezerra¹,

Costa²,

Reiber³

et al. 2015

Int J Cardiovasc Imaging

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“…As described previously, all participants in the parent study were followed longitudinally for mortality 20,27 using both the Social Security Death Index and the National Death Index through the 31 st of December 2010. Patients were cross-referenced with study records to confirm identity.…”

Section: Methodsmentioning

confidence: 99%

Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality

et al. 2017

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Background and aims CVD risks associated with coronary artery calcification (CAC) and aortic calcification (AC) are well known, but less is known about other calcified arteries. We aimed to assess the associations of arterial calcification in the breast, splenic, and internal and external iliac arteries with CVD risk factors and mortality. Methods We conducted a case-cohort study nested in a cohort of 5196 individuals who self-referred or were referred by a health care provider for whole body computed tomography (CT), including a random subcohort (n=395) and total and CVD mortality cases (n=298 and n=90), who died during a median follow-up of 9.4 years. Arterial calcification in the breast, splenic, and internal and external iliac arteries on CT was scored using a simple visual score. AC and CAC were previously measured using the Agatston technique. Logistic regression models were made to study associations of CVD risk factors with calcification in the different vascular beds. Prentice-weighted Cox proportional hazards models adjusted for CVD risk factors, and calcification in other vascular beds, were used to study associations with mortality. Results In the subcohort, the mean age was 56.6 years (SD 11.1) and 41.3% were female. The prevalence of calcification on CT, was 11.6% in the splenic, 47.9% in the internal iliac and 9.5% in the external iliac arteries, while 3.7% of women had breast artery calcification (BAC). Calcification in the splenic and iliac arteries was associated with calcification in the abdominal aorta but differentially associated with other CVD risk factors in logistic regression models. The prevalence of BAC was too low to fit these multivariable models. Calcification of the external iliac arteries was significantly associated with both all-cause and CVD mortality, but no longer significant when adjusted for CVD risk factors. Breast artery calcification was associated with both all-cause and CVD mortality independent of CVD risk factors and AAC and CAC (all-cause HR 5.67 [95% CI 1.50–21.41]). Conclusions Risk factors associated with calcification, and the association of calcification with risk of mortality differ across vascular beds, possibly reflecting different pathophysiology.

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Comparison of ordinal versus Agatston coronary calcification scoring for cardiovascular disease mortality in community-living individuals

Cited by 31 publications

References 13 publications

Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality

Relationship of Coronary Calcium on Standard Chest CT Scans With Mortality

Cardiovascular imaging 2014 in the International Journal of Cardiovascular Imaging

Calcification of the splenic, iliac, and breast arteries and risk of all-cause and cardiovascular mortality

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