OAK BROOK, Ill. —Computed tomography (CT)-based measures of calcification in the abdominal aorta are strong predictors of heart attacks and other adverse cardiovascular events—stronger even than the widely used Framingham risk score, according to a new study published in the journal Radiology

Cardiovascular diseases are the leading cause of death worldwide. Of these deaths, heart disease and stroke are the deadliest. Effective measures of cardiovascular disease risk are crucial in predicting which patients are most in need of early interventions like diet and lifestyle changes, or medications to lower cholesterol.

“We found a strong association between abdominal aortic calcification and future cardiovascular events,” said lead author Stacy D. O’Connor, M.D., M.P.H., assistant professor of radiology at the Medical College of Wisconsin in Milwaukee. “With heart disease being a leading cause of death, anything we can do to make our patients more aware of their risk is going to help.”

The Framingham risk score is a well-known and widely used prediction model for cardiovascular disease based on traditional risk factors like age, cholesterol and blood pressure. However, many patients evaluated by the Framingham risk score fall into an indeterminate risk category and could benefit from additional noninvasive tools for refining risk assessment like measures of atherosclerosis, which is narrowing of the arteries due to plaque buildup. CT is commonly used to measure calcium, a component of plaque, in the coronary arteries.

CT can also measure calcium in the abdominal aorta, the large vessel that carries oxygenated blood to the lower extremities. The abdominal aorta can be seen on abdominal imaging exams like CT colonography, also known as virtual colonoscopy, and in the diagnostic workup for acute cholecystitis, an inflammation of the gallbladder often caused by gallstones.

For the new study, conducted at the University of Wisconsin School of Medicine and Public Health in Madison, researchers assessed the relationship between abdominal aortic calcification on CT and cardiovascular events in 829 asymptomatic patients with a mean age of approximately 58 years. The patients had undergone nonenhanced screening CT colonography between April 2004 and March 2005. The researchers were able to follow the patients for an average of 11 years to see if they had developed adverse cardiovascular events like heart attack, stroke, death or congestive heart failure.

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