Incidental CT can help ID potential heart-attack victims

Incidental chest CT findings can help identify individuals at risk for future heart attacks or other cardiovascular events, according to a study published online in the journal Radiology.

Currently, physicians determine who is at risk for cardiovascular events by looking at conventional risk factors such as age, gender, blood pressure, cholesterol levels, diabetes and smoking status. But, Pushpa Jairam, M.D., Ph.D, of the University Medical Center Utrecht in the Netherlands, and colleagues pointed out that radiologists frequently are confronted with incidental findings during the use of chest CT that suggest early signs of atherosclerosis.

"In addition to diagnostic purposes, chest CT can be used for the prediction of cardiovascular disease," Jairam said, according to an announcement touting the 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."

Jairam and her colleagues attempted to develop and validate an imaging-based prediction model to assess the contribution of incidental findings on CT chest scans in detecting those patients who are at high risk for cardiovascular events. The researchers retrospectively looked at 10,410 patients who underwent diagnostic chest CT  for noncardiovascular indications. During a mean follow-up period of 3.7 years, 1,148 cardiovascular events occurred in these patients. The CT scans from these patients, along with scans from 10 percent of the remaining patients (selected at random) were graded for several cardiovascular findings.

The researchers final prediction model--which included age, gender, CT indication, left anterior descending coronary calcifications, mitral valve calcifications, descending aorta calcifications and cardiac diameter--accurately placed individuals into relevant risk categories.

"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," Jairam said. "The resulting prediction rule may be used to assist clinicians to refer these patients for timely preventive cardiovascular risk management."

Research published earlier this year found that cardiac MRI also can help predict the risk of future cardiovascular events in patients who have suffered heart attacks or are suspected to have cardiovascular disease.

To learn more:
- see the study in Radiology
- read the announcement