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Peer-reviewedCC BYRheumatology (Oxford, England)

Cardiovascular risk stratification using chest CT in idiopathic inflammatory myopathies.

  • Kastriot Kastrati1,2
  • Svitlana Pochepnia3
  • Rade Drača1
  • Florian Prayer3,4
  • Ece Danisman1
  • Daniel Mrak1
  • Thomas M Hofbauer5
  • Daniel Aletaha1
  • Latika Gupta6,7
  • Hector Chinoy8,9
  • Helmut Prosch3
  • Helga Lechner-Radner1
9 affiliations
  1. 1Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
  2. 2Department of Rheumatology, Oslo University Hospital, Oslo, Norway.
  3. 3Division of General and Paediatric Radiology, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
  4. 4Imaging Verbund, Vienna, Austria.
  5. 5Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
  6. 6Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK.
  7. 7School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
  8. 8Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK.
  9. 9Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
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Abstract

Objective

To evaluate the diagnostic and prognostic value of incidentally detected coronary artery calcification (CAC) on routine chest computed tomography (CT) for cardiovascular risk stratification in patients with idiopathic inflammatory myopathies (IIM).Methods

In this single-centre cross-sectional study, adult patients with IIM who underwent non-cardiac, non-gated high-resolution chest CT (HRCT) were included. CAC was visually categorized as absent, mild, moderate or severe. Diagnostic performance for established coronary artery disease (CAD) and established cardiovascular (CV) events was assessed. Kaplan-Meier analyses evaluated CV death-free survival, and multivariable logistic regression identified factors associated with CAC. A matched systemic sclerosis (SSc) cohort served as validation cohort.Results

Among 234 patients with IIM (mean age 57.1 [15.9] years; 70.1% female), CAC was present in 43.2%. Higher CAC thresholds showed greater specificity for established CAD and prior CV events, whereas lower thresholds were more sensitive. CAC was associated with reduced CV death-free survival (log-rank P = 0.0095), with a stepwise decline across CAC severity categories. Findings were similar in the matched SSc cohort. Increasing CAC burden was associated with older age, smoking, higher CV risk burden, interstitial lung disease and higher disease activity. In adjusted analyses, high disease activity was independently associated with moderate CAC (odds ratio [OR] 4.01; 95% CI: 1.29, 12.50), while a higher number of concomitant DMARDs was associated with severe CAC (OR 2.55; 95% CI: 1.27, 5.11).Conclusion

Incidentally detected CAC on routine chest CT provides diagnostic and prognostic information in IIM and may represent a pragmatic approach to improve cardiovascular risk stratification in this high-risk population.

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Cite

BibTeXRIS
BibTeX
@article{kastrati2026cardiovascular,
  title = {{Cardiovascular risk stratification using chest CT in idiopathic inflammatory myopathies.}},
  author = {Kastriot Kastrati and Svitlana Pochepnia and Rade Drača and Florian Prayer and Ece Danisman and Daniel Mrak and Thomas M Hofbauer and Daniel Aletaha and Latika Gupta and Hector Chinoy and Helmut Prosch and Helga Lechner-Radner},
  journal = {Rheumatology (Oxford, England)},
  year = {2026},
  month = oct,
  doi = {10.1093/rheumatology/keag566},
  url = {https://europepmc.org/article/MED/42861766},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cardiovascular risk stratification using chest CT in idiopathic inflammatory myopathies.
AU  - Kastriot Kastrati
AU  - Svitlana Pochepnia
AU  - Rade Drača
AU  - Florian Prayer
AU  - Ece Danisman
AU  - Daniel Mrak
AU  - Thomas M Hofbauer
AU  - Daniel Aletaha
AU  - Latika Gupta
AU  - Hector Chinoy
AU  - Helmut Prosch
AU  - Helga Lechner-Radner
PY  - 2026
DA  - 2026/10/01
JO  - Rheumatology (Oxford, England)
DO  - 10.1093/rheumatology/keag566
UR  - https://europepmc.org/article/MED/42861766
AB  - Objective  To evaluate the diagnostic and prognostic value of incidentally detected coronary artery calcification (CAC) on routine chest computed tomography (CT) for cardiovascular risk stratification in patients with idiopathic inflammatory myopathies (IIM).Methods  In this single-centre cross-sectional study, adult patients with IIM who underwent non-cardiac, non-gated high-resolution chest CT (HRCT) were included. CAC was visually categorized as absent, mild, moderate or severe. Diagnostic performance for established coronary artery disease (CAD) and established cardiovascular (CV) events was assessed. Kaplan-Meier analyses evaluated CV death-free survival, and multivariable logistic regression identified factors associated with CAC. A matched systemic sclerosis (SSc) cohort served as validation cohort.Results  Among 234 patients with IIM (mean age 57.1 [15.9] years; 70.1% female), CAC was present in 43.2%. Higher CAC thresholds showed greater specificity for established CAD and prior CV events, whereas lower thresholds were more sensitive. CAC was associated with reduced CV death-free survival (log-rank P = 0.0095), with a stepwise decline across CAC severity categories. Findings were similar in the matched SSc cohort. Increasing CAC burden was associated with older age, smoking, higher CV risk burden, interstitial lung disease and higher disease activity. In adjusted analyses, high disease activity was independently associated with moderate CAC (odds ratio [OR] 4.01; 95% CI: 1.29, 12.50), while a higher number of concomitant DMARDs was associated with severe CAC (OR 2.55; 95% CI: 1.27, 5.11).Conclusion  Incidentally detected CAC on routine chest CT provides diagnostic and prognostic information in IIM and may represent a pragmatic approach to improve cardiovascular risk stratification in this high-risk population.
SN  - 1462-0324
SN  - 1462-0332
ER  -