Chest CT Helps Predict Risk of Cardiovascular Disease, Study

The risk of a future heart attack and other cardiovascular events can be easily identified by chest computed tomography (CT), a new study reveals.

Currently, the risk of cardiovascular disease can be identified only after analyzing the conventional risk factors that include age, gender and smoking status among others.  But the cardiovascular event may even occur in those without any conventional risk factors.

To identify those at risk, researchers at the University Medical Center Utrecht, Nertherlands, claim that incidental chest CTs help predict the risk of cardiovascular disease.

"In addition to diagnostic purposes, chest CT can be used for the prediction of cardiovascular disease," said Pushpa M. Jairam, M.D., Ph.D., from the University Medical Center Utrecht, Netherlands. "With this study, we have taken a new perspective by providing a different approach for cardiovascular disease risk prediction strictly based on information readily available to the radiologist."

Using chest CT, radiologists often come across findings that are unrelated to the CT indication called incidental findings.  These are the initial signs of atherosclerosis and play a crucial role in identifying individuals at risk of cardiovascular events. Sadly, there is no guidance available currently that helps to weigh the findings during routine practices.

"Extensive literature has clearly documented the uncertainty of prediction models based on conventional risk factors," Dr. Jairam said. "With this study, we address to some extent, the need for a shift in cardiovascular risk assessment from conventional risk factors to direct measures of subclinical atherosclerosis."

In this study the researchers focused on the follow up data that involved 10,410 patients who underwent diagnostic chest CT for non-cardiovascular indications. During the mean follow-up period of 3.7 years, 1,148 cardiovascular events were recorded.

Apart from this, the researchers looked at the data of random 10 percent of the patients and visually marked them  for cardiovascular finding.

The researchers have developed an image based prediction model based on incidental finding on chest CTs in identifying those at risk.

The model included patients' age, gender, CT indication, left anterior descending coronary artery calcifications, mitral valve calcifications, descending aorta calcifications and cardiac diameter.

The model helps to accurately identify those at risk.  This highlights that the radiologic information may help enhance diagnosis and treatment in patients at risk of cardiovascular diseases.

"Our study provides a novel strategy to detect patients at high risk for cardiovascular disease, irrespective of the conventional risk factor status, based on freely available incidental information from a routine diagnostic chest CT," Dr. Jairam said. "The resulting prediction rule may be used to assist clinicians to refer these patients for timely preventive cardiovascular risk management."

The finding was documented in the journal Radiology.