Coronary artery calcifications and 6-month mortality in patients with COVID-19 without known atheromatous disease
Central illustration. Six-month mortality according to category of coronary artery calcium (CAC). The mortality rate increased with the magnitude of calcifications according to a visual scoring of CAC on chest computed tomography. CAC was associated with 6-month mortality, independent of conventiona...
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| description | Central illustration. Six-month mortality according to category of coronary artery calcium (CAC). The mortality rate increased with the magnitude of calcifications according to a visual scoring of CAC on chest computed tomography. CAC was associated with 6-month mortality, independent of conventional cardiovascular risk-factors, in patients hospitalized for coronavirus disease 2019 without known atheromatous disease. CI: confidence interval; HR: hazard ratio. ▪
Coronary artery calcium (CAC) is an independent risk factor for major adverse cardiovascular events; however, its impact on coronavirus disease 2019 (COVID-19) mortality remains unclear, especially in patients without known atheromatous disease.
To evaluate the association between CAC visual score and 6-month mortality in patients without history of atheromatous disease hospitalized with COVID-19 pneumonia.
A single-centre observational cohort study was conducted, involving 293 consecutive patients with COVID-19 in Paris, France, between 13 March and 30 April 2020, with a 6-month follow-up. Patients with a history of ischaemic stroke or coronary or peripheral artery disease were excluded. The primary outcome was all-cause mortality at 6 months according to CAC score, which was assessed by analysing images obtained after the first routine non-electrocardiogram-gated computed tomography scan performed to detect COVID-19 pneumonia.
A total of 251 patients (mean age 64.8±16.7 years) were included in the analysis. Fifty-one patients (20.3%) died within 6 months. The mortality rate increased with the magnitude of calcifications, and was 10/101 (9.9%), 15/66 (22.7%), 10/34 (29.4%) and 16/50 (32.0%) for the no CAC, mild CAC, moderate CAC and heavy CAC groups, respectively (p=0.004). Compared with the no calcification group, adjusted risk of death increased progressively with CAC: hazard ratio (HR) 2.37 (95% confidence interval [CI] 1.06–5.27), HR 3.1 (95% CI 1.29–7.45) and HR 4.02 (95% CI 1.82–8.88) in the mild, moderate and heavy CAC groups, respectively.
Non-electrocardiogram-gated computed tomography during the initial pulmonary assessment of patients with COVID-19 without atherosclerotic cardiovascular disease showed a high prevalence of mild, moderate and heavy CAC. CAC score was related to 6-month mortality, independent of conventional cardiovascular risk factors. These results highlight the importance of CAC scoring for patients hospitalized with COVID-19, and calls for attention to patients with hig |
| doi_str_mv | 10.1016/j.acvd.2022.02.007 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8895715</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1875213622000432</els_id><sourcerecordid>2641503588</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-c455e189802124f209323e35cebf37d194f811e05e7c141e8dba5a83246e80683</originalsourceid><addsrcrecordid>eNp9UU2PFCEQJUbjrqt_wIPhqIceC2i66cSYbMaP3WSSvahXwtDVDmM3zAIzm_330s46UQ8mFQqoV496PEJeMlgwYM3b7cLYQ7_gwPkCSkD7iJwz1cqKM64en_aiOSPPUtoCNLxtm6fkTEgBsmPynNwuQwzexHtqYsaSrBmtG5w12QWfqPE9baop-LyhU4jZjC7fU-fprgDQ50TvXCktb75df6hY9-sU9pn-8OHOU5M3GMNkctgn2ruEJuFz8mQwY8IXD_mCfP308cvyqlrdfL5eXq4qW6sul1VKZKpTUMTUA4dOcIFCWlwPou1ZVw-KMQSJrWU1Q9WvjTRK8LpBBY0SF-T9kXe3X0_Y2zJsNKPeRTcVuToYp_-ueLfR38NBK9XJlslC8OZIsPmn7epypec7qEEyBerACvb1w2Mx3O4xZT25ZHEcjceiXfOmZhKEVPNc_Ai1MaQUcThxM9Czr3qrZ1_17KuGEtCWpld_ijm1_DayAN4dAVi-9OAw6mSLPxZ7F9Fm3Qf3P_6fBKG02Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2641503588</pqid></control><display><type>article</type><title>Coronary artery calcifications and 6-month mortality in patients with COVID-19 without known atheromatous disease</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Le Hir, Anne-Sophie ; Fayol, Antoine ; Mousseaux, Elie ; Danchin, Nicolas ; Tea, Victoria ; Chamandi, Chekrallah ; Soulat, Gilles ; Puymirat, Etienne</creator><creatorcontrib>Le Hir, Anne-Sophie ; Fayol, Antoine ; Mousseaux, Elie ; Danchin, Nicolas ; Tea, Victoria ; Chamandi, Chekrallah ; Soulat, Gilles ; Puymirat, Etienne</creatorcontrib><description>Central illustration. Six-month mortality according to category of coronary artery calcium (CAC). The mortality rate increased with the magnitude of calcifications according to a visual scoring of CAC on chest computed tomography. CAC was associated with 6-month mortality, independent of conventional cardiovascular risk-factors, in patients hospitalized for coronavirus disease 2019 without known atheromatous disease. CI: confidence interval; HR: hazard ratio. ▪
Coronary artery calcium (CAC) is an independent risk factor for major adverse cardiovascular events; however, its impact on coronavirus disease 2019 (COVID-19) mortality remains unclear, especially in patients without known atheromatous disease.
To evaluate the association between CAC visual score and 6-month mortality in patients without history of atheromatous disease hospitalized with COVID-19 pneumonia.
A single-centre observational cohort study was conducted, involving 293 consecutive patients with COVID-19 in Paris, France, between 13 March and 30 April 2020, with a 6-month follow-up. Patients with a history of ischaemic stroke or coronary or peripheral artery disease were excluded. The primary outcome was all-cause mortality at 6 months according to CAC score, which was assessed by analysing images obtained after the first routine non-electrocardiogram-gated computed tomography scan performed to detect COVID-19 pneumonia.
A total of 251 patients (mean age 64.8±16.7 years) were included in the analysis. Fifty-one patients (20.3%) died within 6 months. The mortality rate increased with the magnitude of calcifications, and was 10/101 (9.9%), 15/66 (22.7%), 10/34 (29.4%) and 16/50 (32.0%) for the no CAC, mild CAC, moderate CAC and heavy CAC groups, respectively (p=0.004). Compared with the no calcification group, adjusted risk of death increased progressively with CAC: hazard ratio (HR) 2.37 (95% confidence interval [CI] 1.06–5.27), HR 3.1 (95% CI 1.29–7.45) and HR 4.02 (95% CI 1.82–8.88) in the mild, moderate and heavy CAC groups, respectively.
Non-electrocardiogram-gated computed tomography during the initial pulmonary assessment of patients with COVID-19 without atherosclerotic cardiovascular disease showed a high prevalence of mild, moderate and heavy CAC. CAC score was related to 6-month mortality, independent of conventional cardiovascular risk factors. These results highlight the importance of CAC scoring for patients hospitalized with COVID-19, and calls for attention to patients with high CAC.
La calcification des artères coronaires (CAC) est un facteur de risque indépendant d’événements cardiovasculaires majeurs ; cependant, leur impact sur la mortalité de la maladie à coronavirus 2019 (COVID-19) reste peu clair, en particulier chez les patients sans maladie athéromateuse connue.
Évaluer l’association entre le score visuel de CAC et la mortalité à 6 mois chez les patients sans antécédents de maladie athéromateuse hospitalisés pour une pneumonie à COVID-19.
Étude observationnelle monocentrique ayant inclus 293 patients consécutifs hospitalisés pour une pneumonie à COVID-19, entre le 13 mars et le 30 avril 2020. Les patients ayant des antécédents d’accident vasculaire cérébral ischémique, de coronaropathie, ou d’artériopathie oblitérante des membres inférieurs ont été exclus. Le critère de jugement principal était la mortalité toutes causes confondues à 6 mois selon le score visuel de CAC (obtenu en analysant les images du scanner thoracique non synchronisé à l’ECG réalisé à l’admission pour détecter et quantifier l’atteinte pulmonaire au COVID-19).
Au total, 251 patients (64,8±16,7 ans) ont été inclus dans notre analyse. Cinquante et un patients (20,3 %) sont décédés dans les 6 mois. Le taux de mortalité augmentait avec l’ampleur des calcifications et était de 10/101 (9,9 %), 15/66 (22,7 %), 10/34 (29,4 %) et 16/50 (32,0 %) pour les groupes sans CAC, avec CAC léger, modéré et important, respectivement (p=0,004). Par rapport au groupe sans calcification, le risque ajusté de décès augmentait progressivement avec le CAC : HR 2,37 (IC95 % 1,06–5,27), HR 3,1 (IC95 % 1,29–7,45) et HR 4,02 (IC95 % 1,82–8,88) dans les groupes CAC léger, modéré et important, respectivement.
L’utilisation du scanner thoracique non synchronisé à l’ECG lors de l’évaluation pulmonaire initiale des patients COVID-19 a permis de détecter une forte prévalence de patients présentant des calcifications coronaires à un stade léger, modéré et important. Le score CAC était lié à la mortalité à 6 mois indépendamment des facteurs de risque cardiovasculaire conventionnels. Ces résultats soulignent l’importance de l’intégration du score visuel de CAC pour la stratification du risque chez les patients hospitalisés pour une pneumopathie COVID-19.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2022.02.007</identifier><identifier>PMID: 35305915</identifier><language>eng</language><publisher>Netherlands: Elsevier Masson SAS</publisher><subject>Aged ; Aged, 80 and over ; Brain Ischemia ; Calcium ; Cardiology and cardiovascular system ; Clinical Research ; Coronaropathie ; Coronary Angiography - methods ; Coronary artery disease ; Coronary Artery Disease - diagnosis ; Coronary Vessels ; COVID-19 ; Emerging diseases ; Human health and pathology ; Humans ; Infectious diseases ; Life Sciences ; Lésion myocardique ; Middle Aged ; Mortality ; Mortalité ; Myocardial injury ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Risk stratification ; Santé publique et épidémiologie ; Stratification du risque ; Stroke ; Vascular Calcification - diagnostic imaging</subject><ispartof>Archives of cardiovascular diseases, 2022-05, Vol.115 (5), p.276-287</ispartof><rights>2022 Elsevier Masson SAS</rights><rights>Copyright © 2022 Elsevier Masson SAS. All rights reserved.</rights><rights>Attribution - NonCommercial - NoDerivatives</rights><rights>2022 Elsevier Masson SAS. All rights reserved. 2022 Elsevier Masson SAS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-c455e189802124f209323e35cebf37d194f811e05e7c141e8dba5a83246e80683</citedby><cites>FETCH-LOGICAL-c489t-c455e189802124f209323e35cebf37d194f811e05e7c141e8dba5a83246e80683</cites><orcidid>0000-0002-8076-1445 ; 0000-0002-9893-9694</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1875213622000432$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35305915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-04051808$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Le Hir, Anne-Sophie</creatorcontrib><creatorcontrib>Fayol, Antoine</creatorcontrib><creatorcontrib>Mousseaux, Elie</creatorcontrib><creatorcontrib>Danchin, Nicolas</creatorcontrib><creatorcontrib>Tea, Victoria</creatorcontrib><creatorcontrib>Chamandi, Chekrallah</creatorcontrib><creatorcontrib>Soulat, Gilles</creatorcontrib><creatorcontrib>Puymirat, Etienne</creatorcontrib><title>Coronary artery calcifications and 6-month mortality in patients with COVID-19 without known atheromatous disease</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>Central illustration. Six-month mortality according to category of coronary artery calcium (CAC). The mortality rate increased with the magnitude of calcifications according to a visual scoring of CAC on chest computed tomography. CAC was associated with 6-month mortality, independent of conventional cardiovascular risk-factors, in patients hospitalized for coronavirus disease 2019 without known atheromatous disease. CI: confidence interval; HR: hazard ratio. ▪
Coronary artery calcium (CAC) is an independent risk factor for major adverse cardiovascular events; however, its impact on coronavirus disease 2019 (COVID-19) mortality remains unclear, especially in patients without known atheromatous disease.
To evaluate the association between CAC visual score and 6-month mortality in patients without history of atheromatous disease hospitalized with COVID-19 pneumonia.
A single-centre observational cohort study was conducted, involving 293 consecutive patients with COVID-19 in Paris, France, between 13 March and 30 April 2020, with a 6-month follow-up. Patients with a history of ischaemic stroke or coronary or peripheral artery disease were excluded. The primary outcome was all-cause mortality at 6 months according to CAC score, which was assessed by analysing images obtained after the first routine non-electrocardiogram-gated computed tomography scan performed to detect COVID-19 pneumonia.
A total of 251 patients (mean age 64.8±16.7 years) were included in the analysis. Fifty-one patients (20.3%) died within 6 months. The mortality rate increased with the magnitude of calcifications, and was 10/101 (9.9%), 15/66 (22.7%), 10/34 (29.4%) and 16/50 (32.0%) for the no CAC, mild CAC, moderate CAC and heavy CAC groups, respectively (p=0.004). Compared with the no calcification group, adjusted risk of death increased progressively with CAC: hazard ratio (HR) 2.37 (95% confidence interval [CI] 1.06–5.27), HR 3.1 (95% CI 1.29–7.45) and HR 4.02 (95% CI 1.82–8.88) in the mild, moderate and heavy CAC groups, respectively.
Non-electrocardiogram-gated computed tomography during the initial pulmonary assessment of patients with COVID-19 without atherosclerotic cardiovascular disease showed a high prevalence of mild, moderate and heavy CAC. CAC score was related to 6-month mortality, independent of conventional cardiovascular risk factors. These results highlight the importance of CAC scoring for patients hospitalized with COVID-19, and calls for attention to patients with high CAC.
La calcification des artères coronaires (CAC) est un facteur de risque indépendant d’événements cardiovasculaires majeurs ; cependant, leur impact sur la mortalité de la maladie à coronavirus 2019 (COVID-19) reste peu clair, en particulier chez les patients sans maladie athéromateuse connue.
Évaluer l’association entre le score visuel de CAC et la mortalité à 6 mois chez les patients sans antécédents de maladie athéromateuse hospitalisés pour une pneumonie à COVID-19.
Étude observationnelle monocentrique ayant inclus 293 patients consécutifs hospitalisés pour une pneumonie à COVID-19, entre le 13 mars et le 30 avril 2020. Les patients ayant des antécédents d’accident vasculaire cérébral ischémique, de coronaropathie, ou d’artériopathie oblitérante des membres inférieurs ont été exclus. Le critère de jugement principal était la mortalité toutes causes confondues à 6 mois selon le score visuel de CAC (obtenu en analysant les images du scanner thoracique non synchronisé à l’ECG réalisé à l’admission pour détecter et quantifier l’atteinte pulmonaire au COVID-19).
Au total, 251 patients (64,8±16,7 ans) ont été inclus dans notre analyse. Cinquante et un patients (20,3 %) sont décédés dans les 6 mois. Le taux de mortalité augmentait avec l’ampleur des calcifications et était de 10/101 (9,9 %), 15/66 (22,7 %), 10/34 (29,4 %) et 16/50 (32,0 %) pour les groupes sans CAC, avec CAC léger, modéré et important, respectivement (p=0,004). Par rapport au groupe sans calcification, le risque ajusté de décès augmentait progressivement avec le CAC : HR 2,37 (IC95 % 1,06–5,27), HR 3,1 (IC95 % 1,29–7,45) et HR 4,02 (IC95 % 1,82–8,88) dans les groupes CAC léger, modéré et important, respectivement.
L’utilisation du scanner thoracique non synchronisé à l’ECG lors de l’évaluation pulmonaire initiale des patients COVID-19 a permis de détecter une forte prévalence de patients présentant des calcifications coronaires à un stade léger, modéré et important. Le score CAC était lié à la mortalité à 6 mois indépendamment des facteurs de risque cardiovasculaire conventionnels. Ces résultats soulignent l’importance de l’intégration du score visuel de CAC pour la stratification du risque chez les patients hospitalisés pour une pneumopathie COVID-19.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain Ischemia</subject><subject>Calcium</subject><subject>Cardiology and cardiovascular system</subject><subject>Clinical Research</subject><subject>Coronaropathie</subject><subject>Coronary Angiography - methods</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Vessels</subject><subject>COVID-19</subject><subject>Emerging diseases</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Life Sciences</subject><subject>Lésion myocardique</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Mortalité</subject><subject>Myocardial injury</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Risk stratification</subject><subject>Santé publique et épidémiologie</subject><subject>Stratification du risque</subject><subject>Stroke</subject><subject>Vascular Calcification - diagnostic imaging</subject><issn>1875-2136</issn><issn>1875-2128</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU2PFCEQJUbjrqt_wIPhqIceC2i66cSYbMaP3WSSvahXwtDVDmM3zAIzm_330s46UQ8mFQqoV496PEJeMlgwYM3b7cLYQ7_gwPkCSkD7iJwz1cqKM64en_aiOSPPUtoCNLxtm6fkTEgBsmPynNwuQwzexHtqYsaSrBmtG5w12QWfqPE9baop-LyhU4jZjC7fU-fprgDQ50TvXCktb75df6hY9-sU9pn-8OHOU5M3GMNkctgn2ruEJuFz8mQwY8IXD_mCfP308cvyqlrdfL5eXq4qW6sul1VKZKpTUMTUA4dOcIFCWlwPou1ZVw-KMQSJrWU1Q9WvjTRK8LpBBY0SF-T9kXe3X0_Y2zJsNKPeRTcVuToYp_-ueLfR38NBK9XJlslC8OZIsPmn7epypec7qEEyBerACvb1w2Mx3O4xZT25ZHEcjceiXfOmZhKEVPNc_Ai1MaQUcThxM9Czr3qrZ1_17KuGEtCWpld_ijm1_DayAN4dAVi-9OAw6mSLPxZ7F9Fm3Qf3P_6fBKG02Q</recordid><startdate>20220501</startdate><enddate>20220501</enddate><creator>Le Hir, Anne-Sophie</creator><creator>Fayol, Antoine</creator><creator>Mousseaux, Elie</creator><creator>Danchin, Nicolas</creator><creator>Tea, Victoria</creator><creator>Chamandi, Chekrallah</creator><creator>Soulat, Gilles</creator><creator>Puymirat, Etienne</creator><general>Elsevier Masson SAS</general><general>Elsevier ; Société française de cardiologie [2008-....]</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8076-1445</orcidid><orcidid>https://orcid.org/0000-0002-9893-9694</orcidid></search><sort><creationdate>20220501</creationdate><title>Coronary artery calcifications and 6-month mortality in patients with COVID-19 without known atheromatous disease</title><author>Le Hir, Anne-Sophie ; Fayol, Antoine ; Mousseaux, Elie ; Danchin, Nicolas ; Tea, Victoria ; Chamandi, Chekrallah ; Soulat, Gilles ; Puymirat, Etienne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-c455e189802124f209323e35cebf37d194f811e05e7c141e8dba5a83246e80683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain Ischemia</topic><topic>Calcium</topic><topic>Cardiology and cardiovascular system</topic><topic>Clinical Research</topic><topic>Coronaropathie</topic><topic>Coronary Angiography - methods</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Vessels</topic><topic>COVID-19</topic><topic>Emerging diseases</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Life Sciences</topic><topic>Lésion myocardique</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Mortalité</topic><topic>Myocardial injury</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Risk stratification</topic><topic>Santé publique et épidémiologie</topic><topic>Stratification du risque</topic><topic>Stroke</topic><topic>Vascular Calcification - diagnostic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Le Hir, Anne-Sophie</creatorcontrib><creatorcontrib>Fayol, Antoine</creatorcontrib><creatorcontrib>Mousseaux, Elie</creatorcontrib><creatorcontrib>Danchin, Nicolas</creatorcontrib><creatorcontrib>Tea, Victoria</creatorcontrib><creatorcontrib>Chamandi, Chekrallah</creatorcontrib><creatorcontrib>Soulat, Gilles</creatorcontrib><creatorcontrib>Puymirat, Etienne</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Le Hir, Anne-Sophie</au><au>Fayol, Antoine</au><au>Mousseaux, Elie</au><au>Danchin, Nicolas</au><au>Tea, Victoria</au><au>Chamandi, Chekrallah</au><au>Soulat, Gilles</au><au>Puymirat, Etienne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronary artery calcifications and 6-month mortality in patients with COVID-19 without known atheromatous disease</atitle><jtitle>Archives of cardiovascular diseases</jtitle><addtitle>Arch Cardiovasc Dis</addtitle><date>2022-05-01</date><risdate>2022</risdate><volume>115</volume><issue>5</issue><spage>276</spage><epage>287</epage><pages>276-287</pages><issn>1875-2136</issn><eissn>1875-2128</eissn><abstract>Central illustration. Six-month mortality according to category of coronary artery calcium (CAC). The mortality rate increased with the magnitude of calcifications according to a visual scoring of CAC on chest computed tomography. CAC was associated with 6-month mortality, independent of conventional cardiovascular risk-factors, in patients hospitalized for coronavirus disease 2019 without known atheromatous disease. CI: confidence interval; HR: hazard ratio. ▪
Coronary artery calcium (CAC) is an independent risk factor for major adverse cardiovascular events; however, its impact on coronavirus disease 2019 (COVID-19) mortality remains unclear, especially in patients without known atheromatous disease.
To evaluate the association between CAC visual score and 6-month mortality in patients without history of atheromatous disease hospitalized with COVID-19 pneumonia.
A single-centre observational cohort study was conducted, involving 293 consecutive patients with COVID-19 in Paris, France, between 13 March and 30 April 2020, with a 6-month follow-up. Patients with a history of ischaemic stroke or coronary or peripheral artery disease were excluded. The primary outcome was all-cause mortality at 6 months according to CAC score, which was assessed by analysing images obtained after the first routine non-electrocardiogram-gated computed tomography scan performed to detect COVID-19 pneumonia.
A total of 251 patients (mean age 64.8±16.7 years) were included in the analysis. Fifty-one patients (20.3%) died within 6 months. The mortality rate increased with the magnitude of calcifications, and was 10/101 (9.9%), 15/66 (22.7%), 10/34 (29.4%) and 16/50 (32.0%) for the no CAC, mild CAC, moderate CAC and heavy CAC groups, respectively (p=0.004). Compared with the no calcification group, adjusted risk of death increased progressively with CAC: hazard ratio (HR) 2.37 (95% confidence interval [CI] 1.06–5.27), HR 3.1 (95% CI 1.29–7.45) and HR 4.02 (95% CI 1.82–8.88) in the mild, moderate and heavy CAC groups, respectively.
Non-electrocardiogram-gated computed tomography during the initial pulmonary assessment of patients with COVID-19 without atherosclerotic cardiovascular disease showed a high prevalence of mild, moderate and heavy CAC. CAC score was related to 6-month mortality, independent of conventional cardiovascular risk factors. These results highlight the importance of CAC scoring for patients hospitalized with COVID-19, and calls for attention to patients with high CAC.
La calcification des artères coronaires (CAC) est un facteur de risque indépendant d’événements cardiovasculaires majeurs ; cependant, leur impact sur la mortalité de la maladie à coronavirus 2019 (COVID-19) reste peu clair, en particulier chez les patients sans maladie athéromateuse connue.
Évaluer l’association entre le score visuel de CAC et la mortalité à 6 mois chez les patients sans antécédents de maladie athéromateuse hospitalisés pour une pneumonie à COVID-19.
Étude observationnelle monocentrique ayant inclus 293 patients consécutifs hospitalisés pour une pneumonie à COVID-19, entre le 13 mars et le 30 avril 2020. Les patients ayant des antécédents d’accident vasculaire cérébral ischémique, de coronaropathie, ou d’artériopathie oblitérante des membres inférieurs ont été exclus. Le critère de jugement principal était la mortalité toutes causes confondues à 6 mois selon le score visuel de CAC (obtenu en analysant les images du scanner thoracique non synchronisé à l’ECG réalisé à l’admission pour détecter et quantifier l’atteinte pulmonaire au COVID-19).
Au total, 251 patients (64,8±16,7 ans) ont été inclus dans notre analyse. Cinquante et un patients (20,3 %) sont décédés dans les 6 mois. Le taux de mortalité augmentait avec l’ampleur des calcifications et était de 10/101 (9,9 %), 15/66 (22,7 %), 10/34 (29,4 %) et 16/50 (32,0 %) pour les groupes sans CAC, avec CAC léger, modéré et important, respectivement (p=0,004). Par rapport au groupe sans calcification, le risque ajusté de décès augmentait progressivement avec le CAC : HR 2,37 (IC95 % 1,06–5,27), HR 3,1 (IC95 % 1,29–7,45) et HR 4,02 (IC95 % 1,82–8,88) dans les groupes CAC léger, modéré et important, respectivement.
L’utilisation du scanner thoracique non synchronisé à l’ECG lors de l’évaluation pulmonaire initiale des patients COVID-19 a permis de détecter une forte prévalence de patients présentant des calcifications coronaires à un stade léger, modéré et important. Le score CAC était lié à la mortalité à 6 mois indépendamment des facteurs de risque cardiovasculaire conventionnels. Ces résultats soulignent l’importance de l’intégration du score visuel de CAC pour la stratification du risque chez les patients hospitalisés pour une pneumopathie COVID-19.</abstract><cop>Netherlands</cop><pub>Elsevier Masson SAS</pub><pmid>35305915</pmid><doi>10.1016/j.acvd.2022.02.007</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-8076-1445</orcidid><orcidid>https://orcid.org/0000-0002-9893-9694</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1875-2136 |
| ispartof | Archives of cardiovascular diseases, 2022-05, Vol.115 (5), p.276-287 |
| issn | 1875-2136 1875-2128 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8895715 |
| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Aged, 80 and over Brain Ischemia Calcium Cardiology and cardiovascular system Clinical Research Coronaropathie Coronary Angiography - methods Coronary artery disease Coronary Artery Disease - diagnosis Coronary Vessels COVID-19 Emerging diseases Human health and pathology Humans Infectious diseases Life Sciences Lésion myocardique Middle Aged Mortality Mortalité Myocardial injury Retrospective Studies Risk Assessment Risk Factors Risk stratification Santé publique et épidémiologie Stratification du risque Stroke Vascular Calcification - diagnostic imaging |
| title | Coronary artery calcifications and 6-month mortality in patients with COVID-19 without known atheromatous disease |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T02%3A38%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Coronary%20artery%20calcifications%20and%206-month%20mortality%20in%20patients%20with%20COVID-19%20without%20known%20atheromatous%20disease&rft.jtitle=Archives%20of%20cardiovascular%20diseases&rft.au=Le%20Hir,%20Anne-Sophie&rft.date=2022-05-01&rft.volume=115&rft.issue=5&rft.spage=276&rft.epage=287&rft.pages=276-287&rft.issn=1875-2136&rft.eissn=1875-2128&rft_id=info:doi/10.1016/j.acvd.2022.02.007&rft_dat=%3Cproquest_pubme%3E2641503588%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2641503588&rft_id=info:pmid/35305915&rft_els_id=S1875213622000432&rfr_iscdi=true |