Opportunistic Screening for Coronary Artery Disease: An Untapped Population Health Resource

医学 冠状动脉疾病 业务 资源(消歧) 内科学 人口 疾病 心脏病学 计算机科学 计算机网络 环境卫生
作者
Rubab F. Malik,Kristie J. Sun,Javad Azadi,Brandyn Lau,Seamus P. Whelton,Armin Arbab‐Zadeh,Renée F Wilson,Pamela T. Johnson
出处
期刊:Journal of The American College of Radiology [Elsevier]
卷期号:21 (6): 880-889 被引量:2
标识
DOI:10.1016/j.jacr.2024.02.010
摘要

Coronary artery disease (CAD) is the leading cause of death in the United States. At risk asymptomatic adults are eligible for screening with EKG-gated coronary artery calcium (CAC) CT, which aids in risk stratification and management decision-making. Incidental CAC (iCAC) is easily quantified on chest CT in patients imaged for noncardiac indications; however, radiologists do not routinely report the finding.To determine the clinical significance of CAC identified incidentally on routine chest CT performed for non-cardiac indications.An informationist developed search strategies in MEDLINE, Embase and SCOPUS, and 2 reviewers independently screened results at both the abstract and full text levels. Data extracted from eligible articles included age, rate of iCAC identification, radiologist reporting frequency, impact on downstream medical management, and association of iCAC with patient outcomes.From 359 unique citations, 83 research publications met inclusion criteria. The percentage of patients with iCAC ranged from 9 to 100%. Thirty-one investigations measured association(s) between iCAC and cardiovascular morbidity and mortality, and 29 identified significant correlations, including nonfatal MI, fatal MI, MACE (major adverse cardiovascular event), cardiovascular death, and all cause death. Incidental CAC was present in 20-100% of the patients in these cohorts, but when present, iCAC was reported by radiologists in only 31-44% of cases. Between 18-77% of patients with iCAC were not on preventive medications in studies that reported these data. Seven studies measured the effect of reporting on guideline directed medical therapy and 5 (71%) reported an increase in medication prescriptions after diagnosis of iCAC, with 1 confirming reductions in LDL levels. Twelve investigations reported good concordance between CAC grade on noncardiac CT and Agatston score on EKG-gated cardiac CT, and 10 demonstrated that AI tools can reliably calculate an Agatston score on noncardiac CT.A body of evidence demonstrates that patients with iCAC on routine chest CT are at risk for cardiovascular disease events and death, but are often undiagnosed. Uniform reporting of iCAC in the chest CT impression represents an opportunity for radiology to contribute to early identification of high-risk individuals and potentially reduce morbidity and mortality. AI tools have been validated to calculate Agatston score on routine chest CT and hold the best potential for facilitating broad adoption.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
爱听歌烨华完成签到,获得积分10
1秒前
gll完成签到,获得积分20
2秒前
Sean发布了新的文献求助10
2秒前
2秒前
2秒前
我以為忘了想念完成签到 ,获得积分10
2秒前
帅帅哈完成签到 ,获得积分10
2秒前
杳鸢应助yk采纳,获得200
3秒前
4秒前
4秒前
高手如林完成签到,获得积分10
4秒前
4秒前
4秒前
5秒前
5秒前
猴王完成签到,获得积分10
5秒前
天选猪咪铲屎官完成签到,获得积分10
5秒前
wanci应助哈哈采纳,获得10
6秒前
比目鱼发布了新的文献求助10
6秒前
小鲨鱼完成签到,获得积分10
6秒前
6秒前
zzz完成签到 ,获得积分10
7秒前
加贝完成签到 ,获得积分10
8秒前
小何发布了新的文献求助10
8秒前
8秒前
9秒前
blUe发布了新的文献求助10
9秒前
LEE发布了新的文献求助10
9秒前
Hao发布了新的文献求助10
9秒前
飘123发布了新的文献求助10
10秒前
10秒前
水博士发布了新的文献求助10
11秒前
12秒前
dxy完成签到 ,获得积分10
12秒前
Lyu完成签到,获得积分10
12秒前
13秒前
13秒前
1234发布了新的文献求助10
14秒前
sutu应助LEE采纳,获得10
14秒前
dmr发布了新的文献求助10
15秒前
高分求助中
Licensing Deals in Pharmaceuticals 2019-2024 3000
Effect of reactor temperature on FCC yield 2000
Very-high-order BVD Schemes Using β-variable THINC Method 1020
Impiego dell’associazione acetazolamide/pentossifillina nel trattamento dell’ipoacusia improvvisa idiopatica in pazienti affetti da glaucoma cronico 900
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
錢鍾書楊絳親友書札 600
Geochemistry, 2nd Edition 地球化学经典教科书第二版,不要epub版本 431
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3295946
求助须知:如何正确求助?哪些是违规求助? 2931781
关于积分的说明 8453689
捐赠科研通 2604382
什么是DOI,文献DOI怎么找? 1421675
科研通“疑难数据库(出版商)”最低求助积分说明 661111
邀请新用户注册赠送积分活动 644031