The role of coronary artery calcium scoring in the prediction of coronary artery disease based on non-contrast non-cardiac chest CT scans in airline pilots.
Lin Zhang, Li Li Liu, Zheng Bin Zhu, Yan Xu, Kai Chen, Qing Qing Duan, Yu Kai Li, Jie Gao, Meng Song, Qiu Yu Shen, Shao Jie Zhu, Qing Qing Jin, Jian Ping Wen, Shuo Feng, Ying Lu, Run Du, Bin Ren, Rui Yan Zhang
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引用次数: 0
Abstract
Background: The aim of the present study was to explore the value of coronary artery calcium score (CACS) using non-gated, non-contrast chest computed tomography (NCCT) to predict coronary artery disease (CAD) in airline pilots.
Methods: Pilots with coronary calcification found on NCCT were consecutively enrolled into this study. All received a coronary computed tomography angiography (CCTA) examination. The coronary artery calcium score (CACS) was evaluated on NCCT using the Agatston method. CCTA images were analyzed using a semi-automated software. Coronary Artery Disease Reporting and Data System (CAD-RADS) scoring categorized coronary stenosis.
Results: A total of 217 male pilots were included, of which 49 were diagnosed with significant CAD (CAD-RADS category 3 or higher). Pilots with significant CAD had much higher CACS (324.28 ± 389.02 vs. 39.16 ± 68.88; p < 0.001). Plaque volumetric measurements showed that total plaque volume (1,103.50 ± 285.51 mm3 vs. 913.18 ± 277.45 mm3; p < 0.001) and calcified plaque volume (149.77 ± 160.71 mm3 vs. 36.42 ± 26.86 mm3; p < 0.001) were more pronounced in individuals in the significant CAD group than those in the non-significant CAD group. A multivariate analysis demonstrated that CACS (odds ratio 1.01; 95% confidence interval 1.005-1.014; p < 0.001) was the only independent risk factor of significant CAD but traditional cardiovascular risk factors, pre-existing medication regimens, or prolonged flight duration were not. CACS positively correlated with total plaque volume (r = 0.156; p = 0.027) and calcified plaque volume (r = 0.434; p < 0.001). Receiver operating characteristic curve analysis showed the area under the curve for the CACS in diagnosing significant CAD was 0.891 (p < 0.001).
Conclusions: CACS assessed using NCCT was significantly associated with CAD-RADS category 3 or higher, as confirmed by CCTA, which indicates that it may serve as a robust predictor for diagnosing significant CAD among airline pilots.
背景：本研究的目的是探讨使用非门控、非对比胸部计算机断层扫描（NCCT）的冠状动脉钙化评分（CACS）对航空公司飞行员冠状动脉疾病（CAD）的预测价值。方法：在NCCT上发现冠状动脉钙化的飞行员被连续纳入本研究。所有患者均行冠状动脉ct血管造影（CCTA）检查。采用Agatston法在NCCT上评价冠状动脉钙评分（CACS）。使用半自动软件分析CCTA图像。冠状动脉疾病报告和数据系统（CAD-RADS）评分分类冠状动脉狭窄。结果：共纳入217名男性飞行员，其中49名被诊断为显著CAD （CAD- rads 3类及以上）。冠心病显著的飞行员CACS明显高于其他飞行员(324.28±389.02∶39.16±68.88；p3 vs. 913.18±277.45 mm3；p3 vs. 36.42±26.86 mm3；p p r = 0.156；P = 0.027)、钙化斑块体积(r = 0.434；结论：使用NCCT评估的CACS与CAD- rads类别3或更高相关，CCTA证实了这一点，这表明它可以作为诊断航空公司飞行员显著CAD的稳健预测因子。
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