Progression of Coronary Calcium Detected on Routine Chest CT Enhances Cardiovascular Risk Assessment in Individuals with Inflammatory Bowel Disease: Findings from a Multicenter Study - Summary - MDSpire
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Progression of Coronary Calcium Detected on Routine Chest CT Enhances Cardiovascular Risk Assessment in Individuals with Inflammatory Bowel Disease: Findings from a Multicenter Study
To assess the prognostic value of coronary artery calcium (CAC) progression in predicting major adverse cardiovascular events (MACE) in patients with inflammatory bowel disease (IBD), highlighting its significance.
Key Findings:
CAC progression occurred in 27.6% of patients and significantly predicted MACE (HR 7.41, P < 0.001).
Graded risk associated with CAC progression: relative HR 10.31, absolute HR 8.14, incident HR 5.22 (all P < 0.001).
Adding CAC progression to conventional risk factors improved discrimination (C-index 0.67 vs. 0.73) and reclassification (NRI 0.22, P < 0.001).
Baseline CAC provided modest value (C-index 0.67 vs. 0.68; NRI 0.04, P = 0.021).
CAC progression was also linked to incident AF.
Interpretation:
CAC progression enhances cardiovascular risk stratification in IBD patients beyond conventional factors and baseline CAC, including those with zero baseline CAC, with implications for clinical practice.
Limitations:
Retrospective design may introduce selection bias and limit causal inferences.
Study population limited to two centers in China, affecting generalizability.
Chest CTs were not specifically performed for cardiovascular risk assessment, which may influence results.
Conclusion:
Opportunistic assessment of CAC progression from routine chest CT can significantly improve cardiovascular risk assessment in IBD patients, emphasizing the need for its integration into clinical practice.
