Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study

Background: The correlation between coronary artery calcification (CAC) detected via electrocardiogram-gated computed tomography (ECG-gated CT) and future cardiovascular events has been well-established. Non-ECG-gated CT is simple and widely used, making it suitable for screening. However, the corre...

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Main Authors: Tomitaka Wakaki, Yusuke Takagi, Yuto Ono, Ryosuke Kato, Ken Abe, Hiroyuki Watanabe
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:International Journal of Cardiology: Heart & Vasculature
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352906724002264
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author Tomitaka Wakaki
Yusuke Takagi
Yuto Ono
Ryosuke Kato
Ken Abe
Hiroyuki Watanabe
author_facet Tomitaka Wakaki
Yusuke Takagi
Yuto Ono
Ryosuke Kato
Ken Abe
Hiroyuki Watanabe
author_sort Tomitaka Wakaki
collection DOAJ
description Background: The correlation between coronary artery calcification (CAC) detected via electrocardiogram-gated computed tomography (ECG-gated CT) and future cardiovascular events has been well-established. Non-ECG-gated CT is simple and widely used, making it suitable for screening. However, the correlation between CAC observed via non-ECG-gated CT and cardiovascular and non-cardiovascular events remains unclear. Therefore, we examined the association between coronary calcification detected via non-ECG-gated CT and prognosis. Methods: This non-randomized, retrospective cohort study included 353 consecutive patients with cardiovascular diseases (male/female 229/124; mean age, 68.6 ± 12.7 years) who underwent non-ECG-gated CT between October 1, 2017 and May 31, 2021. Correlations between the Agatston score and cardiovascular and non-cardiovascular events were evaluated. The Agatston scores were divided into three tertiles (low, intermediate, and high) and compared. The primary endpoint was composite cardiovascular events, including cardiac death, myocardial infarction, hospitalization for congestive heart failure, stroke, and unplanned cardiac surgery. The secondary endpoint was composite non-cardiovascular events, including non-cardiovascular death, cancer development, and hospitalization for a non-cardiovascular worsening event. Results: During the median follow-up period of 16.9 (interquartile range, 2.2–38.6) months, 83 patients reached the primary endpoint, while 81 patients reached the secondary endpoint. Kaplan–Meier analysis indicated that patients with high Agatston scores had a significantly higher incidence of cardiovascular and non-cardiovascular events than those with low Agatston scores (p < 0.001). Conclusions: In this study, the Agatston score obtained using non-ECG-gated CT predicted cardiovascular and non-cardiovascular events. Non-ECG-gated CT can be easily performed, aiding early detection in patients with high event rates.
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spelling doaj-art-a35ffa2901c449f5af9dae40d44cff652025-08-20T02:15:37ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-02-015610156010.1016/j.ijcha.2024.101560Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort studyTomitaka Wakaki0Yusuke Takagi1Yuto Ono2Ryosuke Kato3Ken Abe4Hiroyuki Watanabe5Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, JapanDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, JapanDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, JapanDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, JapanDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, JapanCorresponding author at: Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, 1-1-1, Hondoh, Akita City, Akita Prefecture, 010-8543, Japan.; Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, JapanBackground: The correlation between coronary artery calcification (CAC) detected via electrocardiogram-gated computed tomography (ECG-gated CT) and future cardiovascular events has been well-established. Non-ECG-gated CT is simple and widely used, making it suitable for screening. However, the correlation between CAC observed via non-ECG-gated CT and cardiovascular and non-cardiovascular events remains unclear. Therefore, we examined the association between coronary calcification detected via non-ECG-gated CT and prognosis. Methods: This non-randomized, retrospective cohort study included 353 consecutive patients with cardiovascular diseases (male/female 229/124; mean age, 68.6 ± 12.7 years) who underwent non-ECG-gated CT between October 1, 2017 and May 31, 2021. Correlations between the Agatston score and cardiovascular and non-cardiovascular events were evaluated. The Agatston scores were divided into three tertiles (low, intermediate, and high) and compared. The primary endpoint was composite cardiovascular events, including cardiac death, myocardial infarction, hospitalization for congestive heart failure, stroke, and unplanned cardiac surgery. The secondary endpoint was composite non-cardiovascular events, including non-cardiovascular death, cancer development, and hospitalization for a non-cardiovascular worsening event. Results: During the median follow-up period of 16.9 (interquartile range, 2.2–38.6) months, 83 patients reached the primary endpoint, while 81 patients reached the secondary endpoint. Kaplan–Meier analysis indicated that patients with high Agatston scores had a significantly higher incidence of cardiovascular and non-cardiovascular events than those with low Agatston scores (p < 0.001). Conclusions: In this study, the Agatston score obtained using non-ECG-gated CT predicted cardiovascular and non-cardiovascular events. Non-ECG-gated CT can be easily performed, aiding early detection in patients with high event rates.http://www.sciencedirect.com/science/article/pii/S2352906724002264Agatston scoreCardiovascular diseasesElectrocardiographyNeoplasmsPrognosis
spellingShingle Tomitaka Wakaki
Yusuke Takagi
Yuto Ono
Ryosuke Kato
Ken Abe
Hiroyuki Watanabe
Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study
International Journal of Cardiology: Heart & Vasculature
Agatston score
Cardiovascular diseases
Electrocardiography
Neoplasms
Prognosis
title Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study
title_full Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study
title_fullStr Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study
title_full_unstemmed Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study
title_short Prognostic value of coronary calcification detected via non-electrocardiogram-gated computed tomography in patients with cardiovascular disease: A retrospective cohort study
title_sort prognostic value of coronary calcification detected via non electrocardiogram gated computed tomography in patients with cardiovascular disease a retrospective cohort study
topic Agatston score
Cardiovascular diseases
Electrocardiography
Neoplasms
Prognosis
url http://www.sciencedirect.com/science/article/pii/S2352906724002264
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