Prevalence of Coronary Artery Calcification in Non-ECG Gated Staging Chest CT Scans of Patients with Primary Lung Cancer

Introduction: Patients with primary lung cancer have an elevated risk of cardiovascular disease, which requires further assessment. In which, a non-ECG-gated chest CT scan performed for lung cancer staging may be used to reveal coronary artery calcification. Objective: The objective of this study was to determine the prevalence of coronary artery calcification using a non-ECG gated staging chest CT scan in patients with primary lung cancer. Methods: A retrospective review of fifty-one patients with primary lung cancer and at least one staging chest CT was carried out from May 1, 2020, to August 31, 2021, in Thammasat University Hospital. The prevalence of coronary artery calcification identified on the non-ECG gated staging chest CT was documented. Coronary artery calcium scores were analyzed using automated computerized software, employing the Agatston method. The association between coronary artery calcium scores and established cardiovascular disease risk factors, including age, sex, smoking behavior, systolic blood pressure, diabetes mellitus, and serum low-density lipoprotein level was examined. Results: The observed prevalence of coronary artery calcification on non-ECG gated staging chest CT scans was 74.5%. The median coronary artery calcium score was 46.03, with an inter quartile range (IQR) of 0-259.81. Thirteen patients did not have coronary artery calcification, twenty-five patients had coronary artery calcium scores equal to or less than 300, and thir teen patients had scores greater than 300. No significant association was identified between coronary artery calcium scores and cardiovascular disease risk factors. Conclusions: Patients with primary lung cancer have a high prevalence of coronary artery calcification, and coronary artery calcium scores can be calculated from non-ECG gated staging CT chest scans.