Coronary artery calcification predicts cardiovascular complications after sepsis

Gupta, Vedant; Sousa, Matthew; Kraitman, Nathan; Annabathula, Rahul; Vsevolozhskaya, Olga A.; Leung, Steve W.; Sorrell, Vincent L.

doi:10.1016/j.jcrc.2017.11.038

Cited by 13 publications

(7 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Gupta et al 24 demonstrated that CAC stratifies septic patients for cardiovascular complications better than traditional risk factors. CAC score was also evaluated in COVID‐19 patients in smaller trials.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of the “atherosclerotic pabulum” on in‐hospital mortality for SARS‐CoV‐2 infection. Is calcium score able to identify at‐risk patients?

Pergola

Cabrelle

Previtero

et al. 2022

Clinical Cardiology

View full text Add to dashboard Cite

Background Although the primary cause of death in COVID‐19 infection is respiratory failure, there is evidence that cardiac manifestations may contribute to overall mortality and can even be the primary cause of death. More importantly, it is recognized that COVID‐19 is associated with a high incidence of thrombotic complications. Hypothesis Evaluate if the coronary artery calcium (CAC) score was useful to predict in‐hospital (in‐H) mortality in patients with COVID‐19. Secondary end‐points were needed for mechanical ventilation and intensive care unit admission. Methods Two‐hundred eighty‐four patients (63, 25 years, 67% male) with proven severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection who had a noncontrast chest computed tomography were analyzed for CAC score. Clinical and radiological data were retrieved. Results Patients with CAC had a higher inflammatory burden at admission ( d ‐dimer, p = .002; C‐reactive protein, p = .002; procalcitonin, p = .016) and a higher high‐sensitive cardiac troponin I (HScTnI, p = <.001) at admission and at peak. While there was no association with presence of lung consolidation and ground‐glass opacities, patients with CAC had higher incidence of bilateral infiltration ( p = .043) and higher in‐H mortality ( p = .048). On the other side, peak HScTnI >200 ng/dl was a better determinant of all outcomes in both univariate ( p = <.001) and multivariate analysis ( p = <.001). Conclusion The main finding of our research is that CAC was positively related to in‐H mortality, but it did not completely identify all the population at risk of events in the setting of COVID‐19 patients. This raises the possibility that other factors, including the presence of soft, unstable plaques, may have a role in adverse outcomes in SARS‐CoV‐2 infection.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Gupta et al 24 demonstrated that CAC stratifies septic patients for cardiovascular complications better than traditional risk factors.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Impact of the “atherosclerotic pabulum” on in‐hospital mortality for SARS‐CoV‐2 infection. Is calcium score able to identify at‐risk patients?

Pergola

Cabrelle

Previtero

et al. 2022

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…Different groups verified that with the Agatston score = 0, an exclusion of CAC can be reliably detected in non-synchronized chest CT with an NPV of 91.6% [ 22 , 28 ]. Even non-ECG-synchronized CT scans of the abdomen in septic patients reveal the high negative predictive value of cardiovascular events by calcium scoring [ 29 ]. Each patient receives numerous CT scans of the upper abdomen during liver transplant evaluation wherein the heart is largely depicted.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans

Röhl

Hein

Kroencke

et al. 2021

JCM

View full text Add to dashboard Cite

Background: The goal of cardiac evaluation of patients awaiting orthotopic liver transplantation (OLT) is to identify the patients at risk for cardiovascular events (CVEs) in the peri- and postoperative periods by opportunistic evaluation of coronary artery calcium (CAC) in non-gated abdominal computed tomographs (CT). Methods: We hypothesized that in patients with OLT, a combination of Lee’s revised cardiac index (RCRI) and CAC scoring would improve diagnostic accuracy and prognostic impact compared to non-invasive cardiac testing. Therefore, we retrospectively evaluated 169 patients and compared prediction of CVEs by both methods. Results: Standard workup identified 22 patients with a high risk for CVEs during the transplant period, leading to coronary interventions. Eighteen patients had a CVE after transplant and a CAC score > 0. The combination of CAC and RCRI ≥ 2 had better negative (NPV) and positive predictive values (PPV) for CVEs (NPV 95.7%, PPV 81.6%) than standard non-invasive stress tests (NPV 92.0%, PPV 54.5%). Conclusion: The cutoff value of CAC > 0 by non-gated CTs combined with RCRI ≥ 2 is highly sensitive for identifying patients at risk for CVEs in the OLT population.

show abstract

“…Good correlation has been demonstrated between CAC identified on non-gated CT scans and Agatston scores obtained from gated CT scans (> 90% in pooled analysis) 5,6,7,8,9,10 . In non-gated CT scans, the presence of CAC has been associated with worse clinical outcomes; whereas, the absence is linked to morbidity and mortality benefits 10,11,12,13,14,15 .…”

Section: Introductionmentioning

confidence: 99%

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Gupta¹,

Leung²,

Winkler³

et al. 2018

JoVE

Self Cite

View full text Add to dashboard Cite

Coronary artery calcification (CAC) provides an objective measure of coronary artery disease and can readily be identified on non-gated computed tomography (CT) scans with a high correlation with gated cardiac CT scans. This standardized protocol takes a step-wise approach to not only optimizing an image for the identification of calcification but also to distinguishing CAC from other common causes of calcification in the cardiac silhouette. Recognition of CAC on non-gated CT scans helps to identify a very powerful prognostic factor that can influence therapeutic interventions or downstream diagnostic testing without requiring a gated cardiac scan. These non-gated CT scans are often acquired as part of the routine care of the patient, and this data is readily available without another dose of ionizing radiation. This protocol allows for the precise and accurate extraction of this data for the purposes of retrospective data analysis in clinical research studies, but also in the clinical evaluation and management of patients.

show abstract

Coronary artery calcification predicts cardiovascular complications after sepsis

Cited by 13 publications

References 39 publications

Impact of the “atherosclerotic pabulum” on in‐hospital mortality for SARS‐CoV‐2 infection. Is calcium score able to identify at‐risk patients?

Impact of the “atherosclerotic pabulum” on in‐hospital mortality for SARS‐CoV‐2 infection. Is calcium score able to identify at‐risk patients?

Cardiovascular Evaluation of Liver Transplant Patients by Using Coronary Calcium Scoring in ECG-Synchronized Computed Tomographic Scans

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Contact Info

Product

Resources

About