Skip to content
2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603

Abstract

Aims

The aim of this study is to assess the identification of incidental myocardial infarction on non-electrocardiogram-gated computed tomographic scans of the chest and its prognostic significance.

Background

The increased utilization and abundance of thoracic computed tomographic (CT) scans have provided a substrate for potential screening purposes.

Objective

The objective of this study was to evaluate the detection of incidental myocardial infarction on routine non-gated thoracic CT performed for non-cardiac reasons and its associated major cardiovascular events and survival.

Methods

We retrospectively assessed routine non-gated thoracic CT scans of all consecutive individuals aged 18 or above who underwent thoracic CT scans as outpatients at the University of California Davis from January 2015 to December 2015. We evaluated the presence and location of incidental MI on non-gated thoracic CT and compared major adverse cardiac events (MACE) and overall survival in CT-positive infarct individuals with a CT-negative infarct control group.

Results

We reviewed routine thoracic CT scans of 1157 individuals and identified 12 individuals with incidental MI. The mean age of individuals with infarction was 71.4 ± 14.1 years, and 50% were female. All individuals with incidental MI had coronary calcification. Individuals with incidental MI had a higher rate of MACE endpoint (92% . 28%, p=0.0001), number of MACE events (1.1 . 0.3, p<0.001), and lower overall survival (median survival of 67 months . not reached, p=0.023) compared with age and sex-matched controls without incidental MI.

Conclusion

Although small in number relative to the total number of individuals evaluated, subjects with incidental MI on routine non-gated thoracic CT scans have worse cardiovascular outcomes and survival compared with controls without infarction. This study highlights the potential opportunistic screening utility of routine thoracic CTs, which could lead to improved risk stratification and intervention.

This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
Loading

Article metrics loading...

/content/journals/cmir/10.2174/0115734056363863250509093505
2025-05-19
2025-09-28
Loading full text...

Full text loading...

/deliver/fulltext/cmir/21/1/CMIR-21-E15734056363863.html?itemId=/content/journals/cmir/10.2174/0115734056363863250509093505&mimeType=html&fmt=ahah

References

  1. StolzD. MkorombindoT. SchumannD.M. AgustiA. AshS.Y. BafadhelM. BaiC. ChalmersJ.D. CrinerG.J. DharmageS.C. FranssenF.M.E. FreyU. HanM. HanselN.N. HawkinsN.M. KalhanR. KonigshoffM. KoF.W. ParekhT.M. PowellP. Rutten-van MölkenM. SimpsonJ. SinD.D. SongY. SukiB. TroostersT. WashkoG.R. WelteT. DransfieldM.T. Towards the elimination of chronic obstructive pulmonary disease: A Lancet Commission.Lancet20224001035692197210.1016/S0140‑6736(22)01273‑936075255
    [Google Scholar]
  2. KanzaR.E. AyoubS. BonenfantF. Incidental, non-gated thoracic CT angiographic detection of proximal right coronary artery total occlusion associated with acute myocardial infarction.Eur. J. Radiol. Open2020710024510.1016/j.ejro.2020.10024532676523
    [Google Scholar]
  3. LucianoA. LuigiS. MancusoL. VitoD.O. De StasioV. PuglieseL. DonnaC.D. GaraciF. FlorisR. ChiocchiM. Incidental findings of acute myocardial infarction detected during ECG-gated and nongated thoracic CTA: A report of four cases.Radiol. Case Rep.20231882567257310.1016/j.radcr.2023.04.02637255698
    [Google Scholar]
  4. KuettingD. MüllerA. FeisstA. LuetkensJ. DabirD. SchildH.H. ThomasD. Incidental cardiac findings in non–electrocardiogram-gated thoracic computed tomography of intensive care unit patients: Assessment of prevalence and underreporting.J. Thorac. Imaging201833316817510.1097/RTI.000000000000030929189481
    [Google Scholar]
  5. SverzellatiN. ArcadiT. SalvoliniL. DoreR. ZompatoriM. MereuM. BattistaG. MartellaI. ToniF. CardinaleL. MaffeiE. MaggiF. CademartiriF. PirrontiT. Under-reporting of cardiovascular findings on chest CT.Radiol. Med. (Torino)2016121319019910.1007/s11547‑015‑0595‑026519045
    [Google Scholar]
  6. TurkbeyE.B. NacifM.S. GuoM. McClellandR.L. TeixeiraP.B.R.P. BildD.E. BarrR.G. SheaS. PostW. BurkeG. BudoffM.J. FolsomA.R. LiuC.Y. LimaJ.A. BluemkeD.A. Prevalence and correlates of myocardial scar in a US cohort.JAMA2015314181945195410.1001/jama.2015.1484926547466
    [Google Scholar]
  7. CerqueiraM.D. WeissmanN.J. DilsizianV. JacobsA.K. KaulS. LaskeyW.K. PennellD.J. RumbergerJ.A. RyanT. VeraniM.S. American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association.Circulation2002105453954210.1161/hc0402.10297511815441
    [Google Scholar]
  8. BlahaM.J. DeFilippisA.P. Multi-Ethnic Study of Atherosclerosis (MESA).J. Am. Coll. Cardiol.202177253195321610.1016/j.jacc.2021.05.00634167645
    [Google Scholar]
  9. WetscherekM.T.A. McNaughtonE. MajcherV. WetscherekA. SadlerT.J. AlsinbiliA. TehW.H. MooreS.D. PatelN. SmithW.P.W. KrishnanU. Incidental coronary artery calcification on non-gated CT thorax correlates with risk of cardiovascular events and death.Eur. Radiol.20233374723473310.1007/s00330‑023‑09428‑z36705681
    [Google Scholar]
  10. YacoubB. KabakusI.M. SchoepfU.J. GiovagnoliV.M. FischerA.M. WichmannJ.L. MartinezJ.D. SharmaP. RapakaS. SahbaeeP. HoelzerP. BurtJ.R. Varga-SzemesA. EmrichT. Performance of an artificial intelligence-based platform against clinical radiology reports for the evaluation of noncontrast chest CT.Acad. Radiol.202229Suppl. 2S108S11710.1016/j.acra.2021.02.00733714665
    [Google Scholar]
  11. PickhardtP.J. Value-added opportunistic CT screening: State of the art.Radiology2022303224125410.1148/radiol.21156135289661
    [Google Scholar]
/content/journals/cmir/10.2174/0115734056363863250509093505
Loading
/content/journals/cmir/10.2174/0115734056363863250509093505
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test