Author + information
- Harshal R. Patil,
- Rajiv Chhabra,
- James H. O'Keefe,
- John H. Helzberg,
- Kevin F. Kennedy,
- Samantha King,
- Damini Dey and
- Randall C. Thompson
Intrathoracic adipose tissue (IAT) appears to be associated with cardiac events in patients, but it is not clear if it is predictive of CAD in asymptomatic subjects.
348 asymptomatic patients undergoing screening non-contrast CT to determine coronary calcium score (CCS) were studied. IAT volumes were quantified using QFAT software with user-defined range of CT slices covering the heart. We tested 2 nested models. We first created an APRIORI logistic regression model to predict CCS>100 Agatston Units based on traditional risk factors: age, male, smoking, LDL, hypertension, DM, and metabolic syndrome. The next model then added TAT >250 cm3. We computed odds ratios for IAT, and compared c-statistics, and computed the integrated discrimination improvement (IDI) for the nested models.
Of the 348 subjects, 61 (17.5%) had CCS>100 with an average score of 109.5. When IAT >250 was added to the traditional model, it was independently associated with greater risk of CCS>100 (Odds Ratio 2.07, 95% CI (1.01, 4.23) p=0.046) (Figure 1). Compared to the traditional model, the addition of IAT non-significantly increased the c-statistic (0.771 vs 0.778, p=0.54), However there was a significant value of IDI (Absolute IDI=0.017, Relative IDI=14%, p=0.045). IAT was independently associated with metabolic syndrome (OR: 8.92 95% CI (3.2, 24.9) p<.0001)
IAT is an independent predictor of CCS > 100 in asymptomatic subjects and correlates more significantly than traditional risk factors.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Imaging: CT/Multimodality VI
Abstract Category: 20. Imaging: CT/Multimodality
Presentation Number: 1230-370
- 2013 American College of Cardiology Foundation