Prevention & lipidsDiagnostic or prognostic study
Aortic and Cardiac Structure From Routine Computed Tomography (CT) Predict Cardiovascular Risk Beyond PREVENT and Coronary Calcium
- Prognostic model development and external validation study
- LASSO model
- external testing
Authors' conclusion
CT-derived structural cardiac and aortic radiomics identified high-risk patients missed by clinical scores and further stratified risk among CAC risk groups.
Study context
- Population
- Patients with routine chest CT and no prior major adverse cardiac events (MACE), Mass General Brigham (model developed on 13,437 NLST lung cancer screening CTs)external testing
- Participants
- 14,577 patients
- Comparison
- CT radiomics score vs PREVENT and coronary artery calcium (CAC) score
- Outcome
- Discrimination for MACE (Harrel's C-index)
- Follow-up
- Median 5.7 years
Performance
As reported in the abstract
MACE discrimination (C-index)
Radiomics score
0.66
C-index · 95% CI 0.64–0.68
PREVENT
0.61
C-index · 95% CI 0.59–0.63
CAC
0.66
C-index · 95% CI 0.65–0.68
- Radiomics + CAC combined C-index
- 0.69 [95% CI: 0.67-0.71]
- Incident MACE
- 6.2%
Further findings
MACE incidence: high risk by radiomics but not PREVENT vs low risk by both
- High risk by radiomics only (MACE per 1,000 person-years)
- 23.1 [95% CI: 16.7-30.2]
- Low risk by both (MACE per 1,000 person-years)
- 6.5 [95% CI: 5.5-7.5]
- Fold higher MACE incidence
- 3.6
Most predictive features
- Aortic surface-to-volume ratio, LV volume and left atrial short-axis length among the most predictive features of MACE
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Aortic and Cardiac Structure From Routine CT Predict Cardiovascular Risk Beyond PREVENT and Coronary Calcium. JACC Cardiovasc Imaging. Published 20 February 2026. doi:10.1016/j.jcmg.2026.01.006
Summarised from the published abstract; every number is checked against it