(Press-News.org) OAK BROOK, Ill. – Incidental chest computed tomography (CT) findings can help identify individuals at risk for future heart attacks and other cardiovascular events, according to a new study published online in the journal Radiology.
"In addition to diagnostic purposes, chest CT can be used for the prediction of cardiovascular disease," said Pushpa M. Jairam, M.D., Ph.D., from the University Medical Center Utrecht, in Utrecht, the Netherlands. "With this study, we have taken a new perspective by providing a different approach for cardiovascular disease risk prediction strictly based on information readily available to the radiologist."
Currently, individuals at high risk for cardiovascular events are identified through risk stratification tools based on conventional risk factors, such as age, gender, blood pressure, cholestorol levels, diabetes, smoking status or other factors thought to be related to heart disease. However, a substantial number of cardiovascular events occur in individuals with no conventional risk factors, or in patients with undetected or underdiagnosed risk factors.
"Extensive literature has clearly documented the uncertainty of prediction models based on conventional risk factors," Dr. Jairam said. "With this study, we address to some extent, the need for a shift in cardiovascular risk assessment from conventional risk factors to direct measures of subclinical atherosclerosis."
Through the use of chest CT, radiologists are routinely confronted with findings that are unsuspected or unrelated to the CT indication, known as incidental findings. Incidental findings indicating early signs of atherosclerosis are quite common and could play a role in a population-based screening approach to identify individuals at high risk for cardiovascular events. However, there is currently no guidance on how to weigh these findings in routine practice.
Dr. Jairam and colleagues set out to develop and validate an imaging-based prediction model to more accurately assess the contribution of incidental findings on chest CT in detecting patients at high risk for cardiovascular disease.
The retrospective study looked at follow-up data from 10,410 patients who underwent diagnostic chest CT for non-cardiovascular indications. During a mean follow-up period of 3.7 years, 1,148 cardiovascular events occurred among these patients.
CT scans from these patients and from a random sampling of 10 percent of the remaining patients in the group were visually graded for several cardiovascular findings. The final prediction model included age, gender, CT indication, left anterior descending coronary artery calcifications, mitral valve calcifications, descending aorta calcifications and cardiac diameter. The model was found to have accurately placed individuals into clinically relevant risk categories.
The results showed that radiologic information may complement standard clinical strategies in cardiovascular risk screening and may improve diagnosis and treatment in eligible patients.
"Our study provides a novel strategy to detect patients at high risk for cardiovascular disease, irrespective of the conventional risk factor status, based on freely available incidental information from a routine diagnostic chest CT," Dr. Jairam said. "The resulting prediction rule may be used to assist clinicians to refer these patients for timely preventive cardiovascular risk management."
Dr. Jairam cautions that a prospective, multicenter trial is needed to validate the impact of these findings.
INFORMATION:
"Incidental Imaging Findings from Routine Chest CT Used to Identify Subjects at High Risk of Future Cardiovascular Events." Collaborating with Dr. Jairam were Martijn J.A. Gondrie, M.D., Ph.D., Diederick E. Grobbee, M.D., Ph.D., Willem P. Th. M. Mali, M.D., Ph.D., Peter C. A. Jacobs, M.D., Ph.D., and Yolanda van der Graaf, M.D., Ph.D.
This report is a part of the PROVIDI study and is funded by the Netherlands Organization for Scientific Research-Medical Sciences (NWO-MW).
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc..
RSNA is an association of more than 53,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill. (RSNA.org)
For patient-friendly information on chest CT, visit RadiologyInfo.org.
Chest CT helps predict cardiovascular disease risk
2014-05-27
[Attachments] See images for this press release:
ELSE PRESS RELEASES FROM THIS DATE:
An area's level of poverty or wealth may affect the distribution of cancer types
2014-05-27
A new analysis has found that certain cancers are more concentrated in areas with high poverty, while other cancers arise more often in wealthy regions. Also, areas with higher poverty had lower cancer incidence and higher mortality than areas with lower poverty. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study's findings demonstrate the importance of including measures of socioeconomic status in national cancer surveillance efforts.
Overall, socioeconomic status is not related to cancer risk—cancer strikes the rich and ...
E-cigarettes: Not a healthy alternative to smoking
2014-05-27
ARLINGTON HEIGHTS, Ill. (May 27, 2014) – Caveat emptor – or "buyer beware" holds true when it comes to the unknown health effects of e-cigarettes. An article in the June issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), examines risks, including the ongoing dependence on nicotine and the dual use of e-cigarettes and regular cigarettes.
The article examines the idea that one of the initial "health benefits" proposed by e-cigarettes makers was that it would help those who smoke cigarettes ...
Annals of Internal Medicine tip sheet for May 27, 2014
2014-05-27
1. Task Force: Screen high-risk individuals for hepatitis B
The U.S. Preventive Services Task Force (USPSTF) recommends hepatitis B virus (HBV) screening for nonpregnant high-risk adolescents and adults, according to a recommendation statement being published in Annals of Internal Medicine. Up to 2.2 million people in the United States have chronic HBV, and 15 to 25 percent of those infected will die from liver disease or liver cancer. Screening for HBV could identify those who may benefit from treatment. Most people born in the United States have been vaccinated for ...
Inhaling hypertonic saline decreases hospital admissions in children with bronchiolitis
2014-05-26
A team of researchers, led by physicians from Children's Hospital Los Angeles, have found that infants with bronchiolitis who were treated with inhaled hypertonic saline in the emergency department (ED) were less likely to require admission to the hospital compared to infants treated with normal saline.
The study, conducted at Children's Hospital Los Angeles and UCSF Benioff Children's Hospital Oakland, will be published in JAMA Pediatrics on May 26.
Bronchiolitis is a respiratory infection common in infants and young children that results in approximately 150,000 ...
Hot flashes/night sweats solutions: Estrogen therapy vs. Venlafaxine
2014-05-26
BOSTON, MA – A new research study from Brigham and Women's Hospital (BWH) that compares low-dose oral estrogen and low-dose non-hormonal venlafaxine hydrochloride extended release (XR) to placebo were both found effective in reducing the number of hot flashes and night sweats reported by menopausal women. The study is the first clinical trial to simultaneously evaluate estrogen therapy (ET), known as the "gold standard" treatment for hot flashes and night sweats, and a non-hormonal treatment, venlafaxine, a first-line treatment in women who are unwilling or unable to ...
Conflicting conclusions in 2 bronchiolitis studies; editorial explains why
2014-05-26
Less Improvement in Infants with Bronchiolitis After Nebulized Hypertonic Saline Treatment
Bottom Line: Children with bronchiolitis (a common respiratory tract infection that can result in hospitalization) who were treated in the emergency department showed less clinical improvement after receiving nebulized 3 percent hypertonic saline (HS) than infants who received normal saline (NS).
Author: Todd A. Florin, M.D., M.S.C.E., of the Cincinnati Children's Hospital, and colleagues.
Background: Nebulized HS has been shown to increase mucociliary clearance (the clearing ...
Ebola vaccine success highlights dilemma of testing on captive chimps to save wild apes
2014-05-26
The first conservation-specific vaccine trial on captive chimpanzees has proved a vaccine against Ebola virus is both safe and capable of producing a robust immune response in chimpanzees.
This unprecedented study, published in the journal PNAS, shows that 'orphan' vaccines - which never complete the expensive licensing process for human use - can be co-opted for use on wildlife and might be a godsend for highly endangered species such as gorillas and chimpanzees, say researchers.
They suggest that, by ending captive research in an effort to pay back an "ethical ...
From chaos to order: How ants optimize food search
2014-05-26
Ants are capable of complex problem-solving strategies that could be widely applied as optimization techniques. An individual ant searching for food walks in random ways, biologists found. Yet the collective foraging behaviour of ants goes well beyond that, as a mathematical study to be published in the Proceedings of the National Academy of Sciences reveals: The animal movements at a certain point change from chaos to order. This happens in a surprisingly efficient self-organized way. Understanding the ants could help analyze similar phenomena - for instance how humans ...
Relaxation helps pack DNA into a virus
2014-05-26
Researchers at the University of California, San Diego have found that DNA packs more easily into the tight confines of a virus when given a chance to relax, they report in a pair of papers to be published in in the early edition of the Proceedings of the National Academy of Sciences the week of May 26 and the May 30 issue of Physical Review Letters.
DNA is a long, unwieldy molecule that tends to repel itself because it is negatively charged, yet it can spool tightly. Within the heads of viruses, DNA can be packed to near crystalline densities, crammed in by a molecular ...
Breakthrough shows how DNA is 'edited' to correct genetic diseases
2014-05-26
An international team of scientists has made a major step forward in our understanding of how enzymes 'edit' genes, paving the way for correcting genetic diseases in patients.
Researchers at the Universities of Bristol, Münster and the Lithuanian Institute of Biotechnology have observed the process by which a class of enzymes called CRISPR – pronounced 'crisper' – bind and alter the structure of DNA.
The results, published in the Proceedings of the National Academy of Sciences (PNAS) today, provide a vital piece of the puzzle if these genome editing tools are ultimately ...