Coronary artery calcium identified on non-gated chest CT scans - A wasted opportunity to avoid the tragedy

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Coronary artery calcium (CAC) is an independent predictor cardiovascular events. While it traditionally performed utilizing gating with specific acquisition parameters, CAC can be identified in non-gated standard chest computed tomography (CT). This study aimed to assess on CTs, evaluating its correlation coronary lesions angiography (CAG) and prognosis. Methods We retrospectively reviewed patients (pts) who underwent CAG due acute syndrome (ACS) had undergone a prior non-contrast CT. was qualitatively evaluated by visual assessment (mild/moderate/severe) quantitatively assessed using Agatson score stratified terciles. Evaluation investigator blinded report. Results included 114 pts after reviewing 1000 CAGs: 67% male, mean age 68 years, 78% hypertension, 62% dyslipidemia, 38% chronic kidney disease, diabetes. The time difference between CT 23 months. unstable angina 33% pts, NSTEMI 52% STEMI 16%. Significant were found 57% (69% PCI 17% surgical revascularization). classified as mild, moderate severe 31%, 16% respectively. Moderate or significant [OR 22, 95%CI 8–61, p<0.001] all-cause mortality 4, 2–9, p = 0.001]. Pts higher peak troponin than those mild/moderate (1780 vs 315 ng/L, 0.024). Quantitative accurately predicted (AUC 0.81, p<0.001; figure 1A), scores this subgroup (1308 120, p<0.001) strongly correlated SYNTAX (p<0.001). Survival analysis severity shown 1B 1C. most severely calcified the often matched culprit vessel future ACS, 79%, 60% 50% concordance for left anterior descending, circumflex, right artery, 80% formal reporting low 25%, even CAC, where only 2/18 reports mentioned it. Furthermore, statin therapy at CAG. Conclusion evaluation CTs feasible associated extent/severity disease CAG, well mortality. Notwithstanding, underreporting frequent underused, suggesting simple common opportunity preventive care.