Abstract 13145: Multiple Non-coronary Ct-parameters Improve Prediction of Hard Cardiovascular Events Above Coronary Artery Calcium Scoring and Established Risk Factors - the Heinz Nixdorf Recall Study
Objectives: When cardiac computed tomography (CT) is performed for quantification of coronary artery calcium (CAC) score, information on other cardiac and thoracic structures is available which may enhance the prognostic value of this imaging technology.
Methods: Participants without coronary artery disease from the prospective population based Heinz Nixdorf Recall Study were included. CAC-score was quantified from non-contrast electron beam CT and risk factors were measured at index presentation. From CT imaging, epicardial fat (EAT) volume, left atrial (LA) and left ventricular axial area, ascending and descending aortic diameters, as well as presence of aortic, aortic valve, and mitral valve calcification were assessed. Incident cardiovascular events included myocardial infarction, stroke, and cardiovascular death. Cox regression analysis and receiver operating characteristics (ROC) were used to assess the prognostic value of CT-derived parameters.
Results: From 3630 subjects (59 ± 8 years, 46% male), 241 (6.6 %) developed a cardiovascular event during 9.9 ±2.6 years of follow-up. In multivariable Cox regression analysis including Framingham Risk Score, CAC (as log(CAC+1)), and CT-parameters, LA size (Hazard radio (95% confidence interval: 1.21(1.04-1.40) per standard deviation, p=0.012) and EAT volume (1.14(1.01-1.29) per standard deviation, p=0.038) were significantly associated with incident events. Presence of aortic calcification showed a tendency toward higher event rate (1.33(0.97-1.81), p=0.08), while all other CT-derived parameters showed no relevant link (p>0.2). In ROC analysis, LA area, EAT volume and presence of aortic calcification improved prediction of incident events over Framingham Risk Score and CAC (AUC 0.749 to 0.760, p=0.019). Adding the other CT-derived parameters to the model only marginally changed the area under the curve (AUC to 0.762, p=0.49).
Conclusion: Quantification of LA size, EAT volume and presence of aortic calcification from non-contrast enhanced cardiac CT improves the prediction of incident hard cardiovascular events above CAC and established risk factors, indicating that quantification of non-coronary measures may improve the prognostic value of this imaging technology.
Author Disclosures: A.A. Mahabadi: None. N. Lehmann: None. S. Möhlenkamp: None. I. Dykun: None. M. Bauer: None. S. Moebus: None. K. Jöckel: None. R. Erbel: None. H. Kälsch: None.
- © 2014 by American Heart Association, Inc.