Prevention & lipidsCohort study
Opportunistic Cardiovascular Risk Assessment Using Routine Head Computed Tomography (CT) in the Emergency Department
- Retrospective cohort study
- single-centre
Authors' conclusion
Routine CTH scans complement traditional risk factors for cardiovascular risk stratification, identifying subclinical disease in younger patients with favorable risk profiles.
Study context
- Population
- Adults without known cardiovascular disease (CVD) who underwent head CT in the Stanford Health Care ED, August 2020 to August 2024Coronary artery calcium (CAC) cohort n = 2,313
- Participants
- 27,990 adults
- Exposure
- Deep learning model from head CT vs AHA PREVENT risk model variables
- Outcome
- Incident CVD complications (MI, stroke, HF), C-index
Main finding
Incident CVD (C-index)
Difference
0.07
95% CI 0.04–0.10
By group
Computed tomography (CTH)
0.82
Concordance index (C-index) · 95% CI 0.78–0.85
PREVENT
0.75
C-index · 95% CI 0.70–0.79
CTH vs PREVENT
difference 0.07 (95% CI 0.04–0.10)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | CTH | PREVENT | CTH+PREVENT |
|---|---|---|---|
| CAC estimation | |||
| C-index | Not reported in the abstract | Not reported in the abstract | 0.76 (95% CI: 0.72-0.80) |
| AUC for CAC >100 | Not reported in the abstract | Not reported in the abstract | 0.80 (95% CI: 0.73-0.85) |
- CAC estimation: n = 2,313
Reclassification
- Reclassified
- 15.7%
- Vascular calcifications, higher- vs lower-risk
- 30.2% vs 24.8%, P = 0.001
- Brain infarcts, higher- vs lower-risk
- 20.1% vs 5.8%, P < 0.001
- higher-risk patients were younger
Original publication
Opportunistic Cardiovascular Risk Assessment Using Routine Head CT in the Emergency Department. J Am Coll Cardiol. Published 8 April 2026. doi:10.1016/j.jacc.2026.02.5095
Summarised from the published abstract; every number is checked against it