Ordinal Scoring of Coronary Artery Calcification by Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism

Aybay, Muhsin Nuh; Peker, Ahmet; Keskin, Muhammed; Durmaz, Mehmet Sedat; Tolu, İsmet

doi:10.1097/rct.0000000000001199

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…In the study of Vakil et al [29], the presence of CAC was a significant predictor of adverse outcomes during admission (ICU admission, prolonged hospitalisation, or death) and after 6 months, particularly when patients with malignancies were excluded. Similarly, in the study by Albay et al [8], there was a significant relationship between increased CACS and increased mortality. The association between CAC and early mortality is consistent with the hypothesis that myocardial ischaemia can lead to RV dysfunction in PE [28].…”

Section: Discussionmentioning

confidence: 60%

“…Similarly, although abnormal interventricular septal positioning or right ventricular strain and increased pulmonary artery obstruction are markers of adverse prognosis [ 4 ], other studies demonstrate inconsistent results [ 5 , 6 ]. Other measures of RV function, such as contrast medium reflux into the inferior vena cava (IVC), size of the pulmonary arteries, or morphology of the right atrium (RA) and left atrium (LA), and coronary artery calcium (CAC) have not been adequately studied, as demonstrated by contradictory results [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Value of computed tomography pulmonary angiography measurements in predicting 30-day mortality among patients with acute pulmonary embolism

Akcalar Zorlu

2024

Pol J Radiol

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PurposeLate diagnosis is associated with high mortality rates in acute pulmonary embolism (PE), so early diagnosis and risk assessment are crucial. We aim to evaluate computed tomography pulmonary angiography measurements to identify relationships with 30-day mortality in patients with pulmonary embolism. This study investigated the utility of computed tomography pulmonary angiography (CTPA) measures in determining 30-day PE-related mortality and identified various echocardiographic, demographic, and clinical variables that were independently associated with short-term mortality in patients with acute PE.Material and methodsThis retrospective study examined data from July 2018 to April 2023. A total of 118 patients were included in the study. Clinical and demographic characteristics, laboratory findings, echocardiographic data, and CTPA images were retrieved from the electronic database and patient charts.ResultsThe rate of 30-day mortality was 14.41%. Deceased patients were significantly older than survivors (73.53 ± 14.17 vs. 60.23 ± 17.49 years; <i>p</i> = 0.004), but the sex distribution was similar. In multivariable logistic regression, having received radiotherapy for malignancy, high pulmonary artery obstruction index % (> 46.2), high left pulmonary artery diameter (> 23.9 mm), and high coronary artery calcification score (> 5.5) were independently associated with mortality.ConclusionsThese results reveal specific parameters that can assist acute PE management by enabling the identification of critical events. Despite promising results in predicting short-term mortality in acute PE, further prospective cohort studies are needed to confirm the results of the present study.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Value of computed tomography pulmonary angiography measurements in predicting 30-day mortality among patients with acute pulmonary embolism

Akcalar Zorlu

2024

Pol J Radiol

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Prevalence and clinical implications of coronary artery calcium scoring on non-gated thoracic computed tomography: a systematic review and meta-analysis

Osborne-Grinter,

Ali,

Williams

2023

Eur Radiol

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Objectives Coronary artery calcifications (CACs) indicate the presence of coronary artery disease. CAC can be found on thoracic computed tomography (CT) conducted for non-cardiac reasons. This systematic review and meta-analysis of non-gated thoracic CT aims to assess the clinical impact and prevalence of CAC. Methods Online databases were searched for articles assessing prevalence, demographic characteristics, accuracy and prognosis of incidental CAC on non-gated thoracic CT. Meta-analysis was performed using a random effects model. Results A total of 108 studies (113,406 patients) were included (38% female). Prevalence of CAC ranged from 2.7 to 100% (pooled prevalence 52%, 95% confidence interval [CI] 46–58%). Patients with CAC were older (pooled standardised mean difference 0.88, 95% CI 0.65–1.11, p < 0.001), and more likely to be male (pooled odds ratio [OR] 1.95, 95% CI 1.55–2.45, p < 0.001), with diabetes (pooled OR 2.63, 95% CI 1.95–3.54, p < 0.001), hypercholesterolaemia (pooled OR 2.28, 95% CI 1.33–3.93, p < 0.01) and hypertension (pooled OR 3.89, 95% CI 2.26–6.70, p < 0.001), but not higher body mass index or smoking. Non-gated CT assessment of CAC had excellent agreement with electrocardiogram-gated CT (pooled correlation coefficient 0.96, 95% CI 0.92–0.98, p < 0.001). In 51,582 patients, followed-up for 51.6 ± 27.4 months, patients with CAC had increased all cause mortality (pooled relative risk [RR] 2.13, 95% CI 1.57–2.90, p = 0.004) and major adverse cardiovascular events (pooled RR 2.91, 95% CI 2.26–3.93, p < 0.001). When CAC was present on CT, it was reported in between 18.6% and 93% of reports. Conclusion CAC is a common, but underreported, finding on non-gated CT with important prognostic implications. Clinical relevance statement Coronary artery calcium is an important prognostic indicator of cardiovascular disease. It can be assessed on non-gated thoracic CT and is a commonly underreported finding. This represents a significant population where there is a potential missed opportunity for lifestyle modification recommendations and preventative therapies. This study aims to highlight the importance of reporting incidental coronary artery calcium on non-gated thoracic CT. Key Points • Coronary artery calcification is a common finding on non-gated thoracic CT and can be reliably identified compared to gated-CT. • Coronary artery calcification on thoracic CT is associated with an increased risk of all cause mortality and major adverse cardiovascsular events. • Coronary artery calcification is frequently not reported on non-gated thoracic CT.

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Ordinal Scoring of Coronary Artery Calcification by Computed Tomography Pulmonary Angiography in Acute Pulmonary Embolism

Cited by 2 publications

References 21 publications

Value of computed tomography pulmonary angiography measurements in predicting 30-day mortality among patients with acute pulmonary embolism

Value of computed tomography pulmonary angiography measurements in predicting 30-day mortality among patients with acute pulmonary embolism

Prevalence and clinical implications of coronary artery calcium scoring on non-gated thoracic computed tomography: a systematic review and meta-analysis

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