ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1582704
Preoperative assessment of coronary stenosis through ordinary chest CT for patients scheduled total hip or knee arthroplasty
Provisionally accepted
- 1West China Hospital, Sichuan University, Chengdu, China
- 2Modern Hospital of Sichuan, Chengdu, Sichuan Province, China
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Background: Coronary artery calcium (CAC) is one of the main factors causing coronary stenosis and is often identified on ordinary chest computed tomography (CT).This study aims to explore the effectiveness of utilizing routine chest CT for preoperative coronary stenosis assessment in patients scheduled total hip or knee arthroplasty.Between July 2020 and July 2024, a retrospective analysis was conducted, and a total of 293 patients who intended to perform total hip or knee arthroplasty were included from 12,150 chest CT scans. Coronary artery calcium Score (CACS) was used to evaluate coronary stenosis based on the preoperative ordinary chest CT. Correlation between CACS and the degree of coronary artery stenosis determined via the coronary angiography (CAG) and the predictive ability of CACS for coronary artery stenosis ≥ 50% were analyzed.The number of patients with CACS scores ranging from 0 to 499 was the largest, with 139 patients (47.44%). There were 88 patients (30.03%) with coronary artery stenosis ≥ 50%, 40 patients (13.65%) with ≥ 70%, and left anterior descending artery stenosis was the most common, with a total of 72 patients (24.57%). A strong correlation (R = 0.891, p < 0.001) between the degree of coronary stenosis and CACS was observed. A CACS threshold of ≥ 1500 demonstrated a specificity of 100% and a positive predictive value (PPV) of 100% for coronary stenosis of ≥ 50%.Ordinary chest CT is highly effective in evaluating the risk of coronary artery stenosis before total hip or knee arthroplasty, introducing a novel approach to facilitate our surgical decision-making.
Keywords: Coronary artery calcium, Arthroplasty, Coronary Stenosis, ordinary chest CT, Coronary Angiography
Received: 24 Feb 2025; Accepted: 11 Jun 2025.
Copyright: © 2025 Si, Li, Wang, Ma and Duan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haibo Si, West China Hospital, Sichuan University, Chengdu, China
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