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Clinical Trial
. 2017 Apr 28;12(4):e0176557.
doi: 10.1371/journal.pone.0176557. eCollection 2017.

Assessment of coronary artery calcium by chest CT compared with EKG-gated cardiac CT in the multicenter AIDS cohort study

Divay Chandra  1 , Aman Gupta  1 , Joseph K Leader  2 , Meghan Fitzpatrick  1 , Lawrence A Kingsley  3 , Eric Kleerup  4 , Sabina A Haberlen  5 , Matthew J Budoff  4 , Mallory Witt  4 , Wendy S Post  5   6 , Frank C Sciurba  1 , Alison Morris  1
Affiliations
Clinical Trial

Assessment of coronary artery calcium by chest CT compared with EKG-gated cardiac CT in the multicenter AIDS cohort study

Divay Chandra et al. PLoS One. .

Abstract

Rationale: Individuals with HIV are at increased risk for coronary artery disease (CAD). Early detection of subclinical CAD by assessment of coronary artery calcium (CAC) may help risk stratify and prevent CAD events in these individuals. However, the current standard to quantify CAC i.e. Agatston scoring requires EKG-gated cardiac CT imaging.

Objective: To determine if the assessment of CAC using non-EKG-gated chest CT and the Weston scoring system is a useful surrogate for Agatston scores in HIV-infected and HIV-uninfected individuals.

Methods and measurements: CAC was assessed by both the Weston and Agatston score in 108 men enrolled in the Multicenter AIDS Cohort Study.

Results: Participants were 55.2 (IQR 50.4; 59.9) years old and 62 (57.4%) were seropositive for HIV. Inter-observer agreement (rs = 0.94, κ = 90.0%, p<0.001, n = 21) and intra-observer agreement (rs = 0.95, κ = 95.2%, p<0.001, n = 97) for category of Weston score were excellent. Weston scores were associated with similar CAD risk factors as Agatston scores (age, race, HDL cholesterol level, all p<0.05) in our cohort. There was excellent correlation (rs = 0.92, p<0.001) and agreement (κw = 0.77, p<0.001) between Weston and Agatston scores.

Conclusions: This study is the first to examine calcium scoring using chest CT in HIV-infected individuals and to independently validate the Weston score as a surrogate for the Agatston score. In clinical or research settings where EKG-gated cardiac CT is not feasible for the assessment of coronary calcium, Weston scoring by using chest CT should be considered.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. ROC curves for the selection of the optimal cut point for the Weston score that corresponds to the established cut point of 100 (panel A) and 400 (panel B) for the Agatston score.
Fig 2
Fig 2. Correlation between Weston and Agatston scores performed on 108 individuals.
See this image and copyright information in PMC

References

    1. Boccara F, Cohen A. Immune activation and coronary atherosclerosis in HIV-infected women: where are we now, and where will we go next? The Journal of infectious diseases. 2013;208(11):1729–31. Epub 2013/09/18. 10.1093/infdis/jit511 - DOI - PubMed
    1. Obel N, Thomsen HF, Kronborg G, Larsen CS, Hildebrandt PR, Sorensen HT, et al. Ischemic heart disease in HIV-infected and HIV-uninfected individuals: a population-based cohort study. Clin Infect Dis. 2007;44(12):1625–31. 10.1086/518285 - DOI - PubMed
    1. Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet. 2014;384(9939):241–8. 10.1016/S0140-6736(14)60604-8 - DOI - PubMed
    1. Kirsch J, Buitrago I, Mohammed TL, Gao T, Asher CR, Novaro GM. Detection of coronary calcium during standard chest computed tomography correlates with multi-detector computed tomography coronary artery calcium score. The international journal of cardiovascular imaging. 2012;28(5):1249–56. Epub 2011/08/13. 10.1007/s10554-011-9928-9 - DOI - PubMed
    1. Baumgart D, Schmermund A, Goerge G, Haude M, Ge J, Adamzik M, et al. Comparison of electron beam computed tomography with intracoronary ultrasound and coronary angiography for detection of coronary atherosclerosis. Journal of the American College of Cardiology. 1997;30(1):57–64. - PubMed