Authors: Rohanlal Vishwanath, Sarah Gorgis, Varinder Singh, James Iordanou, Hayk Papukhyan, Aeman Hana, Cori Russell, Karthikeyan Ananthasubramaniam.
Coronary artery calcification (CAC) is an independent predictor of cardiovascular events and can be reliably detected on non-Electrocardiogram (ECG) gated computed tomography (CT) scans. The increased use of CT has made CAC a common incidental finding, although the frequency remains variable in published literature. We aimed to identify the incidence of CAC found on routine non-ECG gated CT scans, risk factors associated with these findings, and management outcomes that resulted from discovery of CAC. A systematic review was conducted through literature search using predetermined search criteria. Applicable studies were screened by 3 investigators for eligibility. Data regarding indication for CT imaging, presence of CAC, cardiovascular risk factors, and management outcomes was collected. A total of 3585 study subjects were included for review. CAC was found in 31.2% (n = 1118) patients. Indications for CT imaging were 33.0% lung cancer screening, 16.0% for intrapulmonary pathology, and 50.0% for other reasons. In patients with CAC, the average age was 61.5 + 8.8 years old, 77.2% were male, 41.4% were smokers, 32.2% had hypertension, 31.5% had hyperlipidemia, and 11.2% had diabetes. Patients with CAC were older (p < 0.001), more likely to be smokers (p = 0.002), and more likely to have hyperlipidemia (p < 0.001). The presence of CAC in reports did not significantly alter management plans. In conclusion, traditional cardiovascular risk factors are associated with incidental CAC. Not reporting incidental CAC is a missed opportunity for identification of patient at increased risk of cardiovascular events in the community.
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