Skip to main content
Erschienen in: Heart and Vessels 2/2022

22.07.2021 | Original Article

Association between coronary artery calcium score on non-contrast chest computed tomography and all-cause mortality among patients with congestive heart failure

verfasst von: Kyoko Ota, Rine Nakanishi, Hidenobu Hashimoto, Yuriko Okamura, Ippei Watanabe, Takayuki Yabe, Ryo Okubo, Takanori Ikeda

Erschienen in: Heart and Vessels | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Coronary artery calcium (CAC) score is a robust prognostic tool to predict cardiac events. Although patients with congestive heart failure (CHF) occasionally undergo non-contrast computed tomography (NCCT), the prognostic utility of CAC by NCCT is not widely known. We aimed to determine if CAC measured on NCCT is associated with all-cause mortality (ACM) among patients with CHF. We identified 550 patients admitted due to CHF who underwent NCCT. Patients were categorized into three groups according to CAC scores 0, 1–999, and ≥ 1000. The multivariate Cox proportional hazards model was used to assess if CAC by NCCT was associated with ACM after adjusting for traditional coronary artery disease (CAD) risk factors, brain natriuretic peptide and left ventricular ejection fraction (LVEF). In a subset of 245 patients with invasive coronary angiography (ICA), the associations between CAC scores and ACM were assessed in the multivariate Cox proportional hazards model. Further, we assessed if CAC increased statin use at discharge. During a mean follow-up of 3.3 ± 3.1 years, ACM occurred in 168 patients (30.55%). Compared with patients with CAC 0, those with CAC ≥ 1000 (HR 1.564, 95% CI 0.969–2.524, P = 0.067) were more likely to experience ACM, while those with CAC score 1–999 (HR 0.971, 95% CI 0.673–1.399, P = 0.873) were not. Similarly, a trend toward significance was observed in patients with LVEF < 40% (HR 2.124, 95% CI 0.929–4.856, P = 0.074). In the sub-analysis, patients with CAC ≥ 1000 had increased ACM compared to those with CAC 0, only if ICA ≥ 50% (HR 3.668, 95% CI 1.141–11.797, P = 0.029). Multivariate logistic regression revealed that statin use at discharge was increased with ICA ≥ 50%, but not CAC. The CAC score measured by NCCT tended to be associated with ACM among CHF patients. Statin use was not increased by CAC on NCCT.
Literatur
1.
Zurück zum Zitat Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TQ, Raggi P, Berman DS (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49:1860–1870CrossRef Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Mosler TP, Tseng PH, Flores FR, Callister TQ, Raggi P, Berman DS (2007) Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 49:1860–1870CrossRef
2.
Zurück zum Zitat Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345CrossRef Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA (2008) Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 358:1336–1345CrossRef
3.
Zurück zum Zitat Nakanishi R, Li D, Blaha MJ, Whelton SP, Darabian S, Flores FR, Dailing C, Blumenthal RS, Nasir K, Berman DS, Budoff MJ (2016) All-cause mortality by age and gender based on coronary artery calcium scores. Eur Heart J Cardiovasc Imaging 17:1305–1314CrossRef Nakanishi R, Li D, Blaha MJ, Whelton SP, Darabian S, Flores FR, Dailing C, Blumenthal RS, Nasir K, Berman DS, Budoff MJ (2016) All-cause mortality by age and gender based on coronary artery calcium scores. Eur Heart J Cardiovasc Imaging 17:1305–1314CrossRef
4.
Zurück zum Zitat Nakanishi R, Li D, Blaha MJ, Whelton SP, Matsumoto S, Alani A, Rezaeian P, Blumenthal RS, Budoff MJ (2015) The relationship between coronary artery calcium score and the long-term mortality among patients with minimal or absent coronary artery risk factors. Int J Cardiol 185:275–281CrossRef Nakanishi R, Li D, Blaha MJ, Whelton SP, Matsumoto S, Alani A, Rezaeian P, Blumenthal RS, Budoff MJ (2015) The relationship between coronary artery calcium score and the long-term mortality among patients with minimal or absent coronary artery risk factors. Int J Cardiol 185:275–281CrossRef
5.
Zurück zum Zitat Hecht HS, Cronin P, Blaha MJ, Budoff MJ, Kazerooni EA, Narula J, Yankelevitz D, Abbara S (2017) 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: a report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology. J Cardiovasc Comput Tomogr 11:74–84CrossRef Hecht HS, Cronin P, Blaha MJ, Budoff MJ, Kazerooni EA, Narula J, Yankelevitz D, Abbara S (2017) 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: a report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology. J Cardiovasc Comput Tomogr 11:74–84CrossRef
6.
Zurück zum Zitat Uretsky S, Chokshi N, Kobrinski T, Agarwal SK, Po JR, Awan H, Jagarlamudi A, Gudiwada SP, D’Avino RC, Rozanski A (2015) The interplay of physician awareness and reporting of incidentally found coronary artery calcium on the clinical management of patients who underwent noncontrast chest computed tomography. Am J Cardiol 115:1513–1517CrossRef Uretsky S, Chokshi N, Kobrinski T, Agarwal SK, Po JR, Awan H, Jagarlamudi A, Gudiwada SP, D’Avino RC, Rozanski A (2015) The interplay of physician awareness and reporting of incidentally found coronary artery calcium on the clinical management of patients who underwent noncontrast chest computed tomography. Am J Cardiol 115:1513–1517CrossRef
7.
Zurück zum Zitat Kirsch J, Martinez F, Lopez D, Novaro GM, Asher CR (2017) National trends among radiologists in reporting coronary artery calcium in non-gated chest computed tomography. Int J Cardiovasc Imaging 33:251–257CrossRef Kirsch J, Martinez F, Lopez D, Novaro GM, Asher CR (2017) National trends among radiologists in reporting coronary artery calcium in non-gated chest computed tomography. Int J Cardiovasc Imaging 33:251–257CrossRef
8.
Zurück zum Zitat Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832CrossRef Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832CrossRef
9.
Zurück zum Zitat Teichholz LE, Kreulen T, Herman MV, Gorlin R (1976) Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence of absence of asynergy. Am J Cardiol 37:7–11CrossRef Teichholz LE, Kreulen T, Herman MV, Gorlin R (1976) Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence of absence of asynergy. Am J Cardiol 37:7–11CrossRef
10.
Zurück zum Zitat Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola V, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRef Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola V, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRef
11.
Zurück zum Zitat Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr (1999) ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 33:1756–1824CrossRef Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, Legako RD, Leon DF, Murray JA, Nissen SE, Pepine CJ, Watson RM, Ritchie JL, Gibbons RJ, Cheitlin MD, Gardner TJ, Garson A Jr, Russell RO Jr, Ryan TJ, Smith SC Jr (1999) ACC/AHA guidelines for coronary angiography. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Committee on Coronary Angiography). Developed in collaboration with the Society for Cardiac Angiography and Interventions. J Am Coll Cardiol 33:1756–1824CrossRef
12.
Zurück zum Zitat Budoff MJ, Lutz SM, Kinney GL, Young KA, Hokanson JE, Barr RG, Steiner R, Nath H, Lopez-Garcia C, Duca LM, Rahmani S, Osawa K, Regan EA, Li D, Casaburi R (2018) Coronary artery calcium on noncontrast thoracic computerized tomography scans and all-cause mortality. Circulation 138:2437–2438CrossRef Budoff MJ, Lutz SM, Kinney GL, Young KA, Hokanson JE, Barr RG, Steiner R, Nath H, Lopez-Garcia C, Duca LM, Rahmani S, Osawa K, Regan EA, Li D, Casaburi R (2018) Coronary artery calcium on noncontrast thoracic computerized tomography scans and all-cause mortality. Circulation 138:2437–2438CrossRef
13.
Zurück zum Zitat Jacobs PC, Gondrie MJ, van der Graaf Y, de Koning HJ, Isgum I, van Ginneken B, Mali WPTM (2012) Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer. AJR Am J Roentgenol 198:505–511CrossRef Jacobs PC, Gondrie MJ, van der Graaf Y, de Koning HJ, Isgum I, van Ginneken B, Mali WPTM (2012) Coronary artery calcium can predict all-cause mortality and cardiovascular events on low-dose CT screening for lung cancer. AJR Am J Roentgenol 198:505–511CrossRef
14.
Zurück zum Zitat Hughes-Austin JM, Dominguez A 3rd, Allison MA, Wassel CL, Rifkin DE, Morgan CG, Daniels MR, Ikram U, Knox JB, Wright CM, Criqui MH, Ix JH (2016) Relationship of coronary calcium on standard chest CT scans with mortality. JACC Cardiovasc Imaging 9:152–159CrossRef Hughes-Austin JM, Dominguez A 3rd, Allison MA, Wassel CL, Rifkin DE, Morgan CG, Daniels MR, Ikram U, Knox JB, Wright CM, Criqui MH, Ix JH (2016) Relationship of coronary calcium on standard chest CT scans with mortality. JACC Cardiovasc Imaging 9:152–159CrossRef
15.
Zurück zum Zitat Rozanski A, Gransar H, Shaw LJ, Kim J, Miranda-Peats L, Wong ND, Rana JS, Orakzai R, Hayes SW, Friedman JD, Thomson LE, Polk D, Min J, Budoff MJ, Berman DS (2011) Impact of coronary artery calcium scanning on coronary risk factors and downstream testing the EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) prospective randomized trial. J Am Coll Cardiol 57:1622–1632CrossRef Rozanski A, Gransar H, Shaw LJ, Kim J, Miranda-Peats L, Wong ND, Rana JS, Orakzai R, Hayes SW, Friedman JD, Thomson LE, Polk D, Min J, Budoff MJ, Berman DS (2011) Impact of coronary artery calcium scanning on coronary risk factors and downstream testing the EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) prospective randomized trial. J Am Coll Cardiol 57:1622–1632CrossRef
16.
Zurück zum Zitat Kalia NK, Miller LG, Nasir K, Blumenthal RS, Agrawal N, Budoff MJ (2006) Visualizing coronary calcium is associated with improvements in adherence to statin therapy. Atherosclerosis 185:394–399CrossRef Kalia NK, Miller LG, Nasir K, Blumenthal RS, Agrawal N, Budoff MJ (2006) Visualizing coronary calcium is associated with improvements in adherence to statin therapy. Atherosclerosis 185:394–399CrossRef
17.
Zurück zum Zitat Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J (2019) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/pcna guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol 73:e285–e350CrossRef Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J (2019) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/pcna guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol 73:e285–e350CrossRef
18.
Zurück zum Zitat Hecht H, Blaha MJ, Berman DS, Nasir K, Budoff M, Leipsic J, Blankstein R, Narula J, Rumberger J, Shaw LJ (2017) Clinical indications for coronary artery calcium scoring in asymptomatic patients: expert consensus statement from the society of cardiovascular computed tomography. J Cardiovasc Comput Tomogr 11:157–168CrossRef Hecht H, Blaha MJ, Berman DS, Nasir K, Budoff M, Leipsic J, Blankstein R, Narula J, Rumberger J, Shaw LJ (2017) Clinical indications for coronary artery calcium scoring in asymptomatic patients: expert consensus statement from the society of cardiovascular computed tomography. J Cardiovasc Comput Tomogr 11:157–168CrossRef
19.
Zurück zum Zitat Jacobs PC, Isgum I, Gondrie MJ, Mali WP, van Ginneken B, Prokop M, van der Graaf Y (2010) Coronary artery calcification scoring in low-dose ungated CT screening for lung cancer: interscan agreement. AJR Am J Roentgenol 194:1244–1249CrossRef Jacobs PC, Isgum I, Gondrie MJ, Mali WP, van Ginneken B, Prokop M, van der Graaf Y (2010) Coronary artery calcification scoring in low-dose ungated CT screening for lung cancer: interscan agreement. AJR Am J Roentgenol 194:1244–1249CrossRef
Metadaten
Titel
Association between coronary artery calcium score on non-contrast chest computed tomography and all-cause mortality among patients with congestive heart failure
verfasst von
Kyoko Ota
Rine Nakanishi
Hidenobu Hashimoto
Yuriko Okamura
Ippei Watanabe
Takayuki Yabe
Ryo Okubo
Takanori Ikeda
Publikationsdatum
22.07.2021
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 2/2022
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-021-01906-y

Weitere Artikel der Ausgabe 2/2022

Heart and Vessels 2/2022 Zur Ausgabe

Neu im Fachgebiet Kardiologie

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.