{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T23:05:39Z","timestamp":1794438339989,"version":"4.9.1"},"reference-count":22,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T00:00:00Z","timestamp":1633824000000},"content-version":"unspecified","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2021,9,23]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary artery calcium (CAC) identified on non-gated CT scan of the chest is predictive of major adverse cardiac events (MACE) in multiple studies with guidelines therefore recommending the routine reporting of incidental CAC. These studies have been limited however to the outpatient setting. We aimed to determine the prognostic utility of incidentally identified CAC on CT scan of the chest among hospital inpatients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Consecutive patients (n=740) referred for inpatient non-contrast CT scan of the chest at a tertiary referral hospital (January 2011 to March 2017) were included (n=280) if they had no known history of coronary artery disease, active malignancy or died within 30 days of admission. Scans were assessed for the presence of CAC by visual assessment and quantified by Agatston scoring. Median age was 69 years (IQR: 54\u201382) and 51% were male with a median CAC score of 7 (IQR 0\u2013205). MACE occurred in 140 (50%) patients at 3.5 years median follow-up including 98 deaths. Half of all events occurred within 18 months. Visible CAC was associated with increased MACE (HR) 6.0 (95% CI: 3.7 to 9.7) compared with patients with no visible CAC. This finding persisted after adjusting for cardiovascular risk factors HR 2.4 (95% CI: 1.3 to 4.3) and with both absolute CAC score and CAC score \u226550th percentile.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Incidental CAC identified on CT scan of the chest among hospital inpatients provides prognostic information that is independent of cardiovascular risk factors. These patients may benefit from aggressive risk factor modification given the high event rate in the short term.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2021-001695","type":"journal-article","created":{"date-parts":[[2021,10,11]],"date-time":"2021-10-11T14:15:53Z","timestamp":1633961753000},"page":"e001695","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Incidentally identified coronary artery calcium on non-contrast CT scan of the chest predicts major adverse cardiac events among hospital inpatients"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1025-5480","authenticated-orcid":false,"given":"Christopher","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin C C","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lloyd","family":"Ridley","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekhala","family":"Anjaria","sequence":"additional","affiliation":[{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvan","family":"Meier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Department of Cardiology, Municipal Hospital Triemli, Zurich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Yiannikas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Kritharides","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Naoum","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia"},{"name":"Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,11]]},"reference":[{"key":"2025081611560441000_8.2.e001695.1","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1056\/NEJMoa072100","article-title":"Coronary calcium as a predictor of coronary events in four racial or ethnic groups","volume":"358","author":"Detrano","year":"2008","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025081611560441000_8.2.e001695.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.10.079"},{"key":"2025081611560441000_8.2.e001695.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000068341.61180.55"},{"key":"2025081611560441000_8.2.e001695.4","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2283021006"},{"key":"2025081611560441000_8.2.e001695.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.02.006"},{"key":"2025081611560441000_8.2.e001695.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.005"},{"key":"2025081611560441000_8.2.e001695.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.461"},{"key":"2025081611560441000_8.2.e001695.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.8.850"},{"key":"2025081611560441000_8.2.e001695.9","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.amjcard.2015.02.051","article-title":"The interplay of physician awareness and reporting of incidentally found coronary artery calcium on the clinical management of patients who underwent noncontrast chest computed tomography","volume":"115","author":"Uretsky","year":"2015","journal-title":"Am J Cardiol"},{"key":"2025081611560441000_8.2.e001695.10","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000092"},{"key":"2025081611560441000_8.2.e001695.11","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.15142062"},{"key":"2025081611560441000_8.2.e001695.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2016.11.003"},{"key":"2025081611560441000_8.2.e001695.13","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-T"},{"key":"2025081611560441000_8.2.e001695.14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.580696"},{"key":"2025081611560441000_8.2.e001695.15","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.jcct.2017.03.004","article-title":"Prognostic value of visually detected coronary artery calcification on unenhanced non-gated thoracic computed tomography for prediction of non-fatal myocardial infarction and all-cause mortality","volume":"11","author":"Shao","year":"2017","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2025081611560441000_8.2.e001695.16","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1007\/s00330-012-2726-5","article-title":"Reliable categorisation of visual scoring of coronary artery calcification on low-dose CT for lung cancer screening: validation with the standard Agatston score","volume":"23","author":"Huang","year":"2013","journal-title":"Eur Radiol"},{"key":"2025081611560441000_8.2.e001695.17","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.jcct.2013.05.003","article-title":"Frequency of unrecognized, unreported, or underreported coronary artery and cardiovascular calcification on noncardiac chest CT","volume":"7","author":"Williams","year":"2013","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2025081611560441000_8.2.e001695.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2005.11.002"},{"key":"2025081611560441000_8.2.e001695.19","first-page":"e6218","article-title":"Incidence and implication of coronary artery calcium on non-gated chest computed tomography scans: a large observational cohort","volume":"11","author":"Haller","year":"2019","journal-title":"Cureus"},{"key":"2025081611560441000_8.2.e001695.20","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jcct.2014.11.006","article-title":"Quantification of coronary artery calcium in nongated CT to predict cardiovascular events in male lung cancer screening participants: results of the Nelson study","volume":"9","author":"Takx","year":"2015","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2025081611560441000_8.2.e001695.21","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.5577"},{"key":"2025081611560441000_8.2.e001695.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.02.008"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2021-001695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T18:56:15Z","timestamp":1755370575000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2021-001695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,10,11]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/openhrt-2021-001695"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2021-001695","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}