Should Radiologists Comment on Incidental Findings of Vascular Calcifications Found on Abdominal/Pelvic CT in Patients Less Than 50 Years of Age?
Academic Radiology, 2020
Adam Bernheim, Joel Grunhut, Alex Tang, Ekramul Gofur, Janice Thai, Varun Mehta, Jonathan Stern, Nima Jadidi, Adam Hodes, Bernard Goldwasser, Amrita Arneja, David Krausz, Michael Coords, Steven Peti, Jerel Chacko, David Sarkany
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In brief
Most research on calcified atherosclerosis focuses on older adults. We studied 519 emergency department patients aged 25 to 50 who had abdominopelvic CT, compared those with and without incidental calcified atherosclerosis, and followed them for six years.
Key findings
Incidental abdominopelvic calcified atherosclerosis in patients under 50 was associated with higher triglycerides (128 vs 105 mg/dL) and lower HDL (38 vs 41 mg/dL).
Patients with these calcifications had a higher risk of stroke, heart attack and death over six years of follow-up (p < 0.0001).
Because radiologists are often first to see these calcifications, reporting them in younger patients is valuable.
Abstract
RATIONALE AND OBJECTIVES: To evaluate if incidental abdominopelvic calcified atherosclerosis (ACA) in patients under 50 years of age correlates with cardiovascular disease (CVD) risk factors. Most studies evaluating calcific atherosclerosis and associated increased risk of CVD have concentrated on middle age and older populations. MATERIALS AND METHODS: A retrospective review of 519 emergency department patients, aged 25-50 years, receiving computed tomography (CT) was performed and ACA correlated with lipid panels obtained via chart review. Those with calcified atherosclerosis were subdivided by vessel location and calcification burden (mild, moderate, or severe). Patients were followed for six years. Normality, Wilcoxon-Mann-Whitney, Kruskal-Wallis, and chi-square tests were performed. RESULTS: Two hundred and sixty-nine patients with incidental ACA on CT and 250 without ACA were studied. Atherosclerotic calcifications had a statistically significant correlation with elevated triglyceride (128 mg/dL vs 105 mg/dL; p = 0.0003) and decreased high-density lipoprotein (38 mg/dL vs 41 mg/dL; p = 0.0032) as compared to the control. Patients with ACA were at higher risk of stroke, heart attack, and death (p < 0.0001) during a six-year follow-up period. CONCLUSION: Incidental atherosclerotic calcification on abdominopelvic CT in patients under 50 years of age correlated with elevated triglycerides and decreased high-density lipoprotein as well as higher risk of cardiovascular events. Since radiologists may be the first to identify this finding and CVD is the leading cause of US deaths, proper recognition and reporting of calcification is valuable.
How to cite
Bernheim A, Grunhut J, Tang A, Gofur E, Thai J, Mehta V, et al. Should Radiologists Comment on Incidental Findings of Vascular Calcifications Found on Abdominal/Pelvic CT in Patients Less Than 50 Years of Age? Acad Radiol. 2020;27(8):1057-1062. doi:10.1016/j.acra.2019.10.013