Document Detail


Cardiovascular disease: prediction with ancillary aortic findings on chest CT scans in routine practice.
MedLine Citation:
PMID:  20876722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To predict cardiovascular disease (CVD) in a clinical care population by using prevalent subclinical ancillary aortic findings detected on chest computed tomographic (CT) images.
MATERIALS AND METHODS: The study was approved by the medical ethics committee of the primary participating facility and the institutional review boards of all other participating centers. From a total of 6975 patients who underwent diagnostic contrast material-enhanced chest CT for noncardiovascular indications, a representative sample population of 817 patients plus 347 patients who experienced a cardiovascular event during a mean follow-up period of 17 months were assigned visual scores for ancillary aortic abnormalities--on a scale of 0-8 for calcifications, a scale of 0-4 for plaques, a scale of 0-4 for irregularities, and a scale of 0-1 for elongation. Four Cox proportional hazard models incorporating different sum scores for the aortic abnormalities plus age, sex, and chest CT indication were compared for discrimination and calibration. The prediction model that performed best was chosen and externally validated.
RESULTS: Each aortic abnormality was highly predictive, and all models performed well (c index range, 0.70-0.72; goodness-of-fit P value range, .45-.76). The prediction model incorporating the sum score for aortic calcifications was chosen owing to its good performance (c index, 0.72; goodness-of-fit P = .47) and its applicability to nonenhanced CT scanning. Validation of this model in an external data set also revealed good performance (c index, 0.71; goodness-of-fit P = .25; sensitivity, 46%; specificity, 76%).
CONCLUSION: A derived prediction model incorporating ancillary aortic findings detected on routine diagnostic CT images complements established risk scores and may help to identify patients at high risk for CVD. Timely application of preventative measures may ultimately reduce the number or severity of CVD events.
Authors:
Martijn J A Gondrie; Willem P T M Mali; Peter C Jacobs; Ay L Oen; Yolanda van der Graaf;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-09-28
Journal Detail:
Title:  Radiology     Volume:  257     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-20     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  549-59     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2010.
Affiliation:
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Room Str 6.131, Universiteitsweg 100, PO Box 85500, 3508 GA Utrecht, the Netherlands. m.gondrie@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Aorta, Thoracic / radiography*
Aortic Diseases / radiography*
Cardiovascular Diseases / radiography*
Contrast Media
Female
Humans
Incidental Findings
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Radiography, Thoracic
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media
Comments/Corrections
Comment In:
Radiology. 2010 Nov;257(2):313-4   [PMID:  20959544 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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