Predictive value of coronary calcifications for future cardiac events in asymptomatic patients: underestimation of risk in asymptomatic smokers

Autor: Tobias Rüther, Alexander Becker, Martin Greif, Christoph R. Becker, Gregor S. Zimmermann, Franz von Ziegler
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
medicine.medical_specialty
Time Factors
Computed Tomography Angiography
Coronary Artery Disease
030204 cardiovascular system & hematology
Coronary Angiography
Risk Assessment
Severity of Illness Index
Asymptomatic
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Internal medicine
Multidetector Computed Tomography
medicine
Humans
Radiology
Nuclear Medicine and imaging
Myocardial infarction
Vascular Calcification
Cardiac imaging
Coronary atherosclerosis
Aged
Retrospective Studies
Smokers
business.industry
Smoking
Hazard ratio
Non-Smokers
Middle Aged
Prognosis
medicine.disease
Coronary Vessels
Predictive value
respiratory tract diseases
030104 developmental biology
Coronary artery calcification
Asymptomatic Diseases
behavior and behavior mechanisms
Cardiology
Radiographic Image Interpretation
Computer-Assisted
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
Agatston score
business
Zdroj: The International Journal of Cardiovascular Imaging. 35:1387-1393
ISSN: 1573-0743
1569-5794
Popis: Coronary calcification (CAC) is an established marker for coronary atherosclerosis and has a highly specific predictive value for cardiovascular events. This study aimed to determine the predictive value in the specific group of asymptomatic smokers in comparison to non-smokers. We included 1432 asymptomatic individuals (575 women, 857 men, age 59.2 ± 7.7 years.) in this study. Coronary calcification was calculated by multi-slice computed tomography following a standardized protocol including calcium score (CS). Coronary risk factors were determined at inclusion. After mean observation time of 76.3 ± 8.5 months the patients were contacted and evaluated for cardiovascular events (myocardial infarction, cardiac death and revascularisation). Mean CS was 231 ± 175 in smokers and 239 ± 188 in non-smokers. Cardiovascular events were found in 14.9% of our patients and there were significantly more events in smokers (119 events, 8.3%) than in non-smokers (94 events, 6.6%, p = 0.001). CS > 400 showed a hazard ratio for future cardiac events of 5.1 (95% CI 4.3–7.6) in smokers and 4.4 (95% CI 3.4–6.2) in non-smokers, p = 0.01. Also in smokers determination of CAC is a valuable predictor of future cardiovascular events. In our study smokers showed throughout all score groups a significantly higher risk compared to non-smokers with equal CS. Therefore, CS may underestimate the risk for future cardiac events in smokers compared to non-smokers.
Databáze: OpenAIRE
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