Timm Dirrichs, Presenter: Nothing to Disclose

Tobias Penzkofer MD, Abstract Co-Author: Nothing to Disclose

Sebastian Reinartz MD, Abstract Co-Author: Nothing to Disclose

Thomas Kraus MD, Abstract Co-Author: Nothing to Disclose

Andreas Horst Mahnken MD, Abstract Co-Author: Nothing to Disclose

Christiane Katharina Kuhl MD, Abstract Co-Author: Nothing to Disclose

Goal was to establish extra-coronary thoracic calcification (ECC) as surrogate marker for coronary-artery calcification (CAC) and coronary-heart disease (CHD) which can be evaluated in chest computed tomography (CT)-studies obtained for other, non-cardiac purposes.

501 males (67 ± 8 years) with history of asbestos exposure underwent low-dose, non-cardiac-gated chest-CT for lung-cancer-screening. Qualitative (ECC prevalence) and quantitative (ECC score [ECCS]) was correlated with (a) qualitative and quantitative CAC measures; (b) prevalence of cardiovascular risk-factors, and (c) history of CHD. 

Prevalence of ECC correlated significantly with prevalence of CAC, with cardiovascular risk-factors, and with CHD (r = 0.5; p < 0.001). ECCS was significantly higher (mean 4462 ± 8319, median 2153) in subjects with CHD (n=63) than in subjects without CHD (n=438; mean 2075 ± 3333, median 780), p<0.001. The negative predictive value (NPV) of ECC in CHD-exclusion was 99.3% (95% CI, 93.9-99.9%) with a diagnostic OR of 25.54, p < 0.001).

In this cohort of workers with asbestos exposure, ECC proved to be an independent predictor of both, CAC and CHD. ECC correlates with classical cardiovascular risk-factors and is a powerful tool to exclude subclinical CHD. ECC can be reliably evaluated in chest CT studies acquired for non-cardiac purposes (e.g. lung cancer screening), and can be used to monitor patients in whom CAC is difficult or impossible to assess e.g. after coronary-stenting or CABG.

ECC score, calculated by summation of extra-coronary calcifications, is a useful surrogate for a subject’s CAC-level, and can also serve as direct predictor of a patient's cardiovascular risk. 

Dirrichs, T, Penzkofer, T, Reinartz, S, Kraus, T, Mahnken, A, Kuhl, C, Extra-Coronary Thoracic Calcification on Chest CT for Cardiac Risk Assessment: The "CT Risk" Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014182.html