- Design
- Single-centre cross-sectional study with survival analysis and SSc validation cohort
- Population
- 234 adults with idiopathic inflammatory myopathy who had non-gated chest HRCT
- Primary outcome
- Coronary calcification and cardiovascular death-free survival
- Effect
- CAC in 43.2%; associated with lower CV death-free survival (log-rank P=0.0095)
Patients with idiopathic inflammatory myopathies often have high-resolution chest CT for interstitial lung disease. A Vienna centre graded coronary artery calcification visually on these non-gated scans in 234 adults (mean age 57, 70% women).
Calcification was present in 43%. Its presence was associated with lower cardiovascular death-free survival, falling stepwise with severity, and the findings were similar in a matched systemic sclerosis cohort. Higher thresholds were more specific, and lower ones more sensitive, for established coronary disease. High disease activity was independently linked to moderate calcification (OR 4.01, 95% CI 1.29–12.50).
The study is single-centre and cross-sectional with a survival analysis, and visual grading is less precise than formal scoring. But the information comes free with a scan already done. Myositis carries raised cardiovascular risk that standard calculators may underestimate.
In practice: ask radiologists to report coronary calcification on every chest HRCT in patients with myositis or systemic sclerosis, and treat its presence as a reason to address lipids, blood pressure, smoking and steroid exposure.
- Ask radiologists to report coronary calcification on chest HRCT in myositis and systemic sclerosis.
- Treat visible coronary calcium as a prompt for full cardiovascular risk management.
- Check lipids, blood pressure and smoking in patients with calcification.
- Aim for low disease activity, which was associated with less calcification.
Why it matters
It turns a scan done for the lungs into a free cardiovascular risk test.
Don't overread it
A single-centre study cannot show that acting on calcification improves outcomes.
The statistics, in plain English
An odds ratio of 4.01 with an interval from 1.29 to 12.50 shows a strong but imprecise link between disease activity and calcification.
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