Existing chest scans may be used for predicting surgical risks: Study

Instead of special heart scans, physicians can use images of the chest captured months earlier, and for other reasons, to estimate patients’ risk of heart attack or death during several kinds of major surgeries, a new study shows.

Researchers at NYU Grossman School of Medicine analyzed existing computed tomography (CT) scans to estimate levels of hardened (calcified) fatty plaque deposits in the heart’s three largest blood vessels. They found that patients with greater buildup of this plaque had higher chances of developing serious health issues following surgery.

For their study, the researchers first accessed data from the electronic health record of 2,650 men and women age 45 and older who had undergone surgery unrelated to the heart between January 2016 and September 2020 at NYU Langone hospitals. The information included the type of procedure and instances of death and heart attack, among other factors. All of the patients whose records were used also had undergone a general CT scan of their chests no more than a year before their surgical operations. Those with death or heart attack during the hospitalization for surgery were then identified.

Next, four members of the team who had no formal training in CT interpretation completed a 90-minute training session in which they learned to estimate coronary calcium severity from the imaging. In the scoring system used in the study, plaque buildup in each of the heart’s three major coronary arteries was rated on a three-point scale ranging from “absent” to “severe.” The scores were then combined to a final grade ranging from 0 to 9.

According to the results, patients with scores from 0 to 2 had a 4% or lower risk of major adverse cardiac events (MACE); those with scores from 3 to 5 had an 8% risk; and those with scores from 6 to 9 had an 13% risk. In addition, the calcium estimates were consistent among the physicians, suggesting that the rating system was reliable, the researchers say.

Reference:

Daniel Choi, et al,“A Novel Index of Coronary Artery Calcium From Pre-operative Non-gated Chest Computed Tomography is Associated With Perioperative Cardiovascular Risk.”MEETING American College of Cardiology’s 72nd Annual Scientific Session Together With World Heart Federation’s World Congress of Cardiology.