CT Scan Plaque May Predict Mortality

Abdominal aortic calcification (AAC), or plaque, on abdominal CT scans predicts “obstructive coronary disease and all-cause mortality, and the absence of AAC is a predictor of no obstructive coronary disease,” according to information presented March 14 at the American College of Cardiology 2010 Scientific Sessions, and as reported in TheHeart.org.

“Multivariate analysis showed that AAC adds incremental prognostic information over clinical variables, coronary anatomy, and left ventricular function,” the article continued.

Steven Simpson, MD, and Mouaz Al-Mallah, MD,  of the Henry Ford Heart and Vascular Institute, studied 367 patients who had had abdominal CT scans for various reasons, none of which were because of symptoms of heart disease. Within a year, though, each of them had had a coronary angiopathy. Twenty-seven months later, 65 of them had died. Of the 62 patients showing no AAC, only seven developed heart problems later. Patients ultimately having obstructive coronary artery disease totaled 134.

“It’s worth it as a cardiologist to [look at a previous abdominal scan],” Dr. Simpson said. “It can improve your judgment….Obviously we’re not implying we should order a noncontrast CT of the abdomen for the purposes of a CT coronary calcium score, but since it is free information, we might as well use it. It ups my aggressiveness in some patients.”

In an article in EurekAlert!, Dr. Al-Mallah said, “If you get a CT scan on your abdomen, there’s probably a good chance that image can provide us with more information about the health of your heart arteries. If you have heart disease and abdominal aortic calcifications, your chance of dying is higher than just having heart disease alone.”

Prior research has discovered that coronary artery calcium on CT scans was connected with heart disease and death. Both physicians connected with this current study caution that more lower-risk individuals need to be evaluated before  AAC can be used as a definite indicator.

Related seminar: Abdominal & Thoracic CT/MR/US: Optimizing Practice