Author + information
The implications of abdominal aortic calcium (AAC), a common incidental finding on non-contrast abdominal computed tomography, are relatively unexplored. The aim of this analysis is to determine the prognostic value of incidental AAC and its impact on Risk Reclassification.
We included 4345 consecutive patients (44% male) without chest pain, prior coronary artery disease, peripheral vascular disease or malignancy who underwent non-contrast abdominal CT for clinical reasons (68% assessment of possible renal colic). Incidental AAC was defined as any aortic calcification from the takeoff of the celiac artery to aortic bifurcation. The primary outcome was all cause mortality as determined by the social security death index.
Incidental AAC was present in 1700 patients (39%). Patients with AAC were older with higher prevalence of hypertension, diabetes, and dyslipidemia (p<0.0001). After a mean follow-up of 4.8 years, 134 patients died from all causes. Using Cox multivariate analysis, incidental AAC was an independent predictor of all cause mortality (Hazard ratio 2.4, 95% CI 1.7-4.1, p<0.0001) after adjusting for confounders. Incorporation of incidental AAC into death risk assessment models resulted in an increase in the c-index from 0.726 to 0.762 (p=0.0037) and in a net reclassification improvement of 9.3%, p=0.013.
Incidental AAC is a powerful, independent predictor of mortality in asymptomatic patients without known or suspected coronary artery disease. It provides meaningful incremental risk stratification over Framingham risk score and should impact the management of these patients.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality V
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1228M-354
- 2013 American College of Cardiology Foundation