Coronary calcium score in COVID-19 survivors: Association with cardiac injury and cardiac function after 6 weeks

Groen, Roos Annelot; Graaf, Michiel A. de; Stöger, J. Lauran; Dijkman, Paul R. M. van; Jukema, J. Wouter; Schalij, Martin J.; Geelhoed, J.J. Miranda; Antoni, M. Louisa

doi:10.1016/j.ahjo.2023.100280

Cited by 4 publications

(4 citation statements)

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“…CAC is a composite measure that considers both the extent and density of calcified lesions, providing a weighted evaluation of their presence in a given area [ 20 ]. CAC, used as an important and non-invasive instrument to assess the presence and degree of atherosclerosis, stands out as the foremost predictor for long-term, cause-specific mortality across various patient demographics, including age, ethnicity, sex, and risk factors [ 21 , 22 ]. In our study, during COVID-19, while the proportion of absent coronary artery calcium scores decreased slightly from 56.9 to 51.6%, there was relative stability in mild scores (26.1%).…”

Section: Discussionmentioning

confidence: 99%

Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic

Zamfir,

Cernomaz,

Ciuntu

et al. 2024

Healthcare

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Background: In the wake of the coronavirus disease 19 (COVID-19) pandemic, affecting healthcare systems globally, urgent research is needed to understand its potential repercussions on the diagnosis and management of cardiovascular disorders. This emphasises the importance of detecting coronary artery anomalies (CAAs), rare conditions that can range from benign to potentially life-threatening manifestations. We aimed to retrospectively assess the impact of the COVID-19 pandemic on the detection of various coronary anomalies using Coronary Computed Tomography Angiography (CCTA) within a regional tertiary cardiology unit in north-eastern Romania, focusing on perceived occurrence in the population under study, types, and related demographic and clinical factors. Methods: We analysed CCTA scans and investigated the trends in CAA detection among cardiology patients over a decade. We compared pre-COVID-19 and pandemic-era data to assess the impact of healthcare utilisation, patient behaviour, and diagnostic approaches on anomaly detection. Results: Our analysis revealed a higher detection rate of CAAs during the pandemic (3.9% versus 2.2%), possibly highlighting differences in patient clinical profile and addressability changes presentation compared to the previous period. Origination and course anomalies, often linked to severe symptoms, were significantly higher pre-COVID-19 (64.1% versus 51.3%). Conversely, intrinsic CAAs, typically asymptomatic or manifesting later in life, notably increased during the pandemic (49.0% versus 61.4%; p = 0.020). Conclusions: Our study underscores a significant rise in CAA detection during the COVID-19 era, potentially linked to changes in cardiovascular and respiratory clinical patterns, with advanced imaging modalities like CCTA offering accuracy in identification.

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Section: Discussionmentioning

confidence: 99%

Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic

Zamfir,

Cernomaz,

Ciuntu

et al. 2024

Healthcare

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“…The CAC score has been shown to be a reliable and quantitative predictor utilizing various scoring systems such as Agatston score and volume score 12 , 20 . CAC score can be readily assessed on a routinely performed CT scan of the chest, which is currently routinely performed in nearly all admitted COVID-19 patients for evaluation of pulmonary disease severity and the extent of lung dysfunction 21 – 25 . In a study conducted by Giannini et al .…”

Section: Discussionmentioning

confidence: 99%

Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran

Hedayati Goudarzi,

Abrotan,

Ziaie

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Coronary artery calcification (CAC) has been established as an independent risk factor for major adverse cardiovascular events. Nevertheless, the effect of CAC on in-hospital mortality and adverse clinical outcomes in patients with COVID-19 has yet to be determined. Objective: To investigate the association between CAC score and in-hospital mortality of COVID-19 patients Method: This retrospective cohort study was conducted across tertiary hospitals of University of Medical Sciences in Babol, a northern city in Iran, and enroled 551 confirmed COVID-19 patients with definitive clinical outcomes of death or discharge between March and October 2021. Demographic and clinical data, along with chest computed tomography (CT) findings and CAC score on admission, were systematically collected. The study utilized logistic regression analysis and Kaplan-Meier plots to explore the association between CAC score and in-hospital death and adverse clinical outcomes. Results: The mean age was 60.05±12.8. A significant difference regarding CAC score, age, history of hypertension, hyperlipidemia, cardiovascular diseases, and respiratory diseases among survivors and non-survivors was observed; however, gender was not found to be different. Furthermore, in multivariate analysis, CAC score greater than or equal to 400 [odds ratio (OR): 4.2, 95% CI: 1.70–10.33, P value: 0.002], hospitalization time (OR: 1.31, 95% CI: 1.13–1.53, P value < 0.001), length of ICU stay (OR: 2.02, 95% CI: 1.47–2.77, P value < 0.001), severe or critical COVID-19 severity in time of admission (95% CI: 1.79–18.29, P value: 0.003), and history of respiratory diseases (95% CI: 2.18–40, P value: 0.003) were found to be associated with higher odds of in-hospital mortality. Log-rank test also revealed a significant difference regarding the time of admission to death between patients with CAC score greater than or equal to 400 and those with CAC score less than 400 (P value < 0.001). Conclusion: Elevated CAC score is a crucial risk factor linked to in-hospital mortality and unfavourable clinical results in confirmed COVID-19 patients. This finding emphasizes the need for careful monitoring of individuals with high CAC scores.

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“…Coronary artery calcification, assessed through chest computed tomography, has been shown to be associated with the features of myocardial injury in COVID-19 survivors. The cardiac troponin serum level was significantly higher in patients with coronary artery calcification than those without coronary calcification (19.3 ± 18.0 ng/L vs. 10.3 ± 10.8 ng/L; p < 0.01) [ 133 ]. In patients at least fifty years old with well-controlled human immunodeficiency virus infection and without evidence of coronary artery disease, it has been found that troponin T and troponin I correlate significantly with the Agatston score ( r = 0.27 and r = 0.28, respectively; p < 0.001) [ 134 ].…”

Section: Cardiac Troponin Serum Level and Subclinical Cardiovascular ...mentioning

confidence: 99%

Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events

Jakubiak

2024

JPM

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Cardiac troponin serum concentration is the primary marker used for the diagnosis of acute coronary syndrome. Moreover, the measurement of cardiac troponin concentration is important for risk stratification in patients with pulmonary embolism. The cardiac troponin level is also a general marker of myocardial damage, regardless of etiology. The purpose of this study is to conduct a literature review and present the most important information regarding the current state of knowledge on the cardiac troponin serum concentration in patients with chronic cardiovascular disease (CVD), as well as on the relationships between cardiac troponin serum concentration and features of subclinical cardiovascular dysfunction. According to research conducted to date, patients with CVDs, such as chronic coronary syndrome, chronic lower extremities’ ischemia, and cerebrovascular disease, are characterized by higher cardiac troponin concentrations than people without a CVD. Moreover, the literature data indicate that the concentration of cardiac troponin is correlated with markers of subclinical dysfunction of the cardiovascular system, such as the intima–media thickness, pulse wave velocity, ankle–brachial index, coronary artery calcium index (the Agatston score), and flow-mediated dilation. However, further research is needed in various patient subpopulations and in different clinical contexts.

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Coronary calcium score in COVID-19 survivors: Association with cardiac injury and cardiac function after 6 weeks

Cited by 4 publications

References 36 publications

Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic

Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic

Coronary artery calcification score as a prognostic indicator for COVID-19 mortality: evidence from a retrospective cohort study in Iran

Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events

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