News | Computed Tomography (CT) | October 12, 2018

Abdominal Aortic Calcification May Signal Future Heart Attack

CT-based measurement of calcification may improve risk assessment for individuals in indeterminate range with traditional risk scores

Images from computed tomography (CT) colonography show segmented abdominal aortic calcification measured with semiautomated CT tool on coronal image. Within region of interest over aorta selected by user, tool automatically segments and quantifies aortic calcification (shown in blue). 

Image Credit: O’Connor S D, Graffy P M, Zea R, et al. Does nonenhanced CT-based quantification of abdominal aortic calcification outperform the Framingham Risk Score in predicting cardiovascular event sin asymptomatic adults? Radiology doi: 10.1148/radiol.2018180562. Published online Oct. 2, 2018. © RSNA.

October 12, 2018 — Computed tomography (CT)-based measures of calcification in the abdominal aorta are strong predictors of heart attacks and other adverse cardiovascular events — stronger even than the widely used Framingham risk score. These assertions are according to a new study published in the journal Radiology.1

Cardiovascular diseases are the leading cause of death worldwide. Of these deaths, heart disease and stroke are the deadliest. Effective measures of cardiovascular disease risk are crucial in predicting which patients are most in need of early interventions like diet and lifestyle changes, or medications to lower cholesterol.

“We found a strong association between abdominal aortic calcification and future cardiovascular events,” said lead author Stacy D. O’Connor, M.D., MPH, assistant professor of radiology at the Medical College of Wisconsin in Milwaukee. “With heart disease being a leading cause of death, anything we can do to make our patients more aware of their risk is going to help.”

The Framingham risk score is a well-known and widely used prediction model for cardiovascular disease based on traditional risk factors like age, cholesterol and blood pressure. However, many patients evaluated by the Framingham risk score fall into an indeterminate risk category and could benefit from additional noninvasive tools for refining risk assessment like measures of atherosclerosis, which is narrowing of the arteries due to plaque buildup. CT is commonly used to measure calcium, a component of plaque, in the coronary arteries.

CT can also measure calcium in the abdominal aorta, the large vessel that carries oxygenated blood to the lower extremities. The abdominal aorta can be seen on abdominal imaging exams like CT colonography, also known as virtual colonoscopy, and in the diagnostic workup for acute cholecystitis, an inflammation of the gallbladder often caused by gallstones.

For the new study, conducted at the University of Wisconsin School of Medicine and Public Health in Madison, researchers assessed the relationship between abdominal aortic calcification on CT and cardiovascular events in 829 asymptomatic patients with a mean age of approximately 58 years. The patients had undergone non-enhanced screening CT colonography between April 2004 and March 2005. The researchers were able to follow the patients for an average of 11 years to see if they had developed adverse cardiovascular events like heart attack, stroke, death or congestive heart failure.

Of the 829 patients, 156 (18.8 percent) had a major cardiovascular event. The events occurred almost seven years after CT, on average, and included heart attack in 39 and death in 79. CT-based abdominal aortic calcification was a strong predictor of future cardiovascular events, outperforming the Framingham risk score. Abdominal aortic calcification was more than five times higher, on average, among those who had a cardiovascular event than those who did not.

The results point to the potential of abdominal aortic calcification assessment as an opportunistic screening tool — something that could be added to other exams without the need for additional patient time or radiation dose. Patients could be assigned to preventive treatment regimens based on their cardiovascular risk categories.

“There are thousands of CT scans performed every day across the United States, so this gives us an opportunity to reach a lot of people,” O’Connor said. “For instance, if someone is getting a scan for cholecystitis and we see abdominal aortic calcification on the CT, we can address things like blood pressure and cholesterol with the patient.”

The researchers plan to build on their results by studying larger groups of patients. They also intend to move toward a fully-automated protocol for more widespread implementation of the assessment.

“It’s our hope that these opportunistic measures can be added to reports for patients undergoing routine abdominal CT, regardless of the imaging indication,” O’Connor said.

For more information: www.pubs.rsna.org/journal/radiology

Reference

1. O’Connor S.D., Graffy P.M., Zea R., Pickhardt P.J. Does Nonenhanced CT-based Quantification of Abdominal Aortic Calcification Outperform the Framingham Risk Score in Predicting Cardiovascular Events in Asymptomatic Adults? Radiology, Oct. 2, 2018. https://doi.org/10.1148/radiol.2018180562

 

Related Content

Philips Launches Zenition Mobile C-arm Platform
Technology | Mobile C-Arms | February 18, 2019
Philips announced the launch of Philips Zenition, its new mobile C-arm imaging platform. Mobile C-arms are X-ray...
Amazon Comprehend Medical Brings Medical Language Processing to Healthcare
News | Artificial Intelligence | February 15, 2019
Amazon recently announced Amazon Comprehend Medical, a new HIPAA-eligible machine learning service that allows...
Fujifilm Exhibits Enterprise Imaging Solutions and Artificial Intelligence Initiative at HIMSS 2019
News | Enterprise Imaging | February 15, 2019
Fujifilm Medical Systems U.S.A. Inc. and Fujifilm SonoSite Inc. showcased their enterprise imaging and informatics...
IBM Watson Health Announces New AI Collaborations With Leading Medical Centers
News | Artificial Intelligence | February 14, 2019
IBM Watson Health announced plans to make a 10-year, $50 million investment in research collaborations with two...
Siemens Healthineers Demonstrates Artificial Intelligence, Healthcare Digitalization at HIMSS19
News | Artificial Intelligence | February 13, 2019
February 13, 2019 — At the 2019 Healthcare Information and Management Systems Society (HIMSS) global conference and e
PaxeraHealth Launching Universal Image Sharing Platform at ECR 2019
News | PACS Accessories | February 13, 2019
PaxeraHealth will launch the PaxeraShare image sharing platform at the 2019 European Congress of Radiology (ECR) annual...
NVIDIA Explores Role of AI, Analytics and Virtualization in Healthcare at HIMSS19
News | Artificial Intelligence | February 13, 2019
Digital technology company NVIDIA will highlight its newest partnerships to advance the digital transformation of...
Philips Launches Latest Iteration of IntelliSpace Cardiovascular at HIMSS 2019
Technology | Cardiac PACS | February 13, 2019
Philips announced the launch of IntelliSpace Cardiovascular 4.1, its next-generation cardiovascular image and...
Hologic Launches Unifi Analytics Business Intelligence Tool
Technology | Analytics Software | February 12, 2019
Hologic Inc. announced the U.S. launch of Unifi Analytics, a business intelligence tool that allows healthcare...
Canon Adds Radiation Therapy Package to Aquilion Prime, Lightning CT Systems
News | Computed Tomography (CT) | February 11, 2019
In the patient-centric world of radiation oncology, it is critical that computed tomography (CT) simulation is...