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Cardiovascular Health

Coronary Artery Calcium (CAC)

Epidemiology & Progression:

Coronary Artery Calcium (CAC) is a marker of atherosclerotic plaque burden and is highly prevalent, increasing with age; found incidentally on ~40-60% of non-gated chest CTs [12]. CAC score strongly predicts future cardiovascular events (heart attack, stroke). Progression is common, with average annual increases in Agatston scores, indicating worsening atherosclerosis [13].

Clinical Value:

Identifying and quantifying CAC, even qualitatively on non-gated CTs, provides crucial prognostic information beyond traditional risk factors [12, 14]. Tracking CAC allows for risk stratification and initiation/intensification of preventative therapies (statins, lifestyle changes) per guidelines [ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease]. Ignoring incidental CAC misses opportunities for primary prevention and risk reduction.

Return on Investment (ROI):

Tracking incidental CAC identifies patients needing cardiology referral and preventative management. Based on proprietary modeling for a medium-sized hospital system, systematic CAC follow-up can generate an estimated $14.7 million in additional net revenue over five years (70% vs 30% capture) through appropriate consultations, further cardiac testing (stress tests, CTAs), and long-term management, improving cardiovascular outcomes [Thynk Health ROI Data, 2025].

Feature List:

  • NLP for CAC Detection: Identifies mentions of CAC (even qualitative) in non-gated chest CT reports. 

  • Cardiology Referral Workflow: Triggers notifications/tasks for cardiology review or consultation based on CAC presence/severity. 

  • Integration with Risk Calculators (Potential Feature): Could incorporate CAC findings into cardiovascular risk assessments. 

Aneurysm Tracking

Epidemiology & Progression:

Abdominal aortic aneurysms (AAA) affect up to 5-7% of men over 65, while thoracic aortic aneurysms (TAA) are less common but also increase with age [15]. Aneurysms often grow slowly (1-4 mm/year), but growth rate accelerates with size. Rupture risk increases exponentially with diameter, particularly >5.5 cm for AAA and >6.0 cm for TAA, carrying high mortality (~80%) [16, ACR Appropriateness Criteria®].

Clinical Value:

Tracking aneurysm size according to established guidelines (e.g., Society for Vascular Surgery, ACR) is critical for determining surveillance intervals and timing of elective repair [16, ACR Appropriateness Criteria®]. Timely intervention significantly reduces rupture risk and mortality compared to emergency surgery. Failure to track aneurysms risks catastrophic rupture due to missed growth or exceeding repair thresholds [17].

Return on Investment (ROI):

Consistent aneurysm tracking ensures guideline-adherent surveillance and timely referrals for vascular surgery consults and elective repair. Based on proprietary modeling for a medium-sized hospital system, this proactive management via Thynk Health can capture an estimated $4.6 million in additional net revenue over five years (70% vs 30% capture) through imaging, consultations, and high-value surgical interventions, while preventing costly emergent cases [Thynk Health ROI Data, 2025].

Feature List:

  • NLP for Aneurysm Measurement: Extracts aneurysm type (AAA, TAA) and diameter measurements from reports. 

  • Guideline-Based Surveillance Scheduling: Automates follow-up imaging schedules based on current size and growth rate (e.g., SVS guidelines). 

  • Size Threshold Alerts: Flags patients whose aneurysm size approaches or exceeds thresholds for surgical consultation/repair. 

  • Vascular Surgery Referral Workflow: Automates referral tasks based on size/growth criteria. 

Valvular Calcification

Epidemiology & Progression:

Aortic valve calcification (AVC) is common in older adults, present on CT in over 50% of those >65 years old, and is a precursor to aortic stenosis (AS) [18]. Mitral annular calcification (MAC) is also prevalent. While often asymptomatic initially, progression can lead to significant valvular dysfunction (stenosis or regurgitation) requiring intervention. Severe AS prevalence is estimated at 2-7% in those >65 [19].

Clinical Value:

Incidental detection of valvular calcification on CT warrants clinical correlation and often echocardiography to assess hemodynamic significance [18, 20]. Tracking allows for monitoring progression and timely referral to cardiology for management, including potential valve replacement for severe, symptomatic disease [ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease]. Ignoring these findings can lead to delayed diagnosis of severe valve disease and associated heart failure or sudden death.

Return on Investment (ROI):

Identifying patients with significant valvular calcification facilitates appropriate cardiac workup. While specific ROI data for isolated valvular calcification tracking isn't available in the provided memory, systems managing related cardiovascular findings like CAC show significant gains. Proactive tracking likely yields substantial ROI through echocardiograms, cardiology consults, and eventual high-revenue valve interventions (TAVR, SAVR), estimated to be in the millions of dollars over 5 years for a medium-sized system by preventing patient leakage for these procedures [Educated Estimate based on CAC ROI & Procedure Costs, 21]. 

Feature List:

  • NLP for Valve Calcification: Detects mentions of aortic or mitral valve calcification in CT reports. 

  • Echocardiogram Recommendation Trigger: Suggests or flags patients for echocardiogram based on significant calcification findings. 

  • Cardiology Referral Workflow: Facilitates referral for further valve assessment. 

Important Note on ROI: The Return on Investment (ROI) figures presented are derived from Thynk Health's proprietary performance data analysis. These calculations are based on models simulating a medium-sized hospital system processing approximately 600,000 CT scans annually through emergency departments and utilizing multispecialty guidelines for follow-up care pathways and associated downstream revenue capture. Actual ROI may vary based on specific institutional factors, patient populations, and payer mix.  

References: 
[12] Hecht, H. S., et al. (2017). Coronary Artery Calcium Scanning: Clinical and Prognostic Impact. JACC: Cardiovascular Imaging. 
[13] Lehmann, N., et al. (2014). Coronary artery calcium progression: a landmark study. JACC: Cardiovascular Imaging. 
[14] ACR–SPR–SSR Practice Parameter for the Performance and Interpretation of Cardiac Computed Tomography (CT). 
[15] Upchurch Jr, G. R., & Schaub, T. A. (2006). Abdominal aortic aneurysm. American family physician. 
[16] Chaikof, E. L., et al. (2018). The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. Journal of vascular surgery. 
[17] ACR Appropriateness Criteria® Pulsatile Abdominal Mass Suspected Abdominal Aortic Aneurysm. 
[18] Messika-Zeitoun, D., et al. (2007). Assessment and clinical implications of aortic valve calcification measured by electron-beam computed tomography. Circulation. 
[19] Osnabrugge, R. L., et al. (2013). Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. JACC: Cardiovascular Interventions. 
[20] Otto, C. M., et al. (2021). 2020 ACC/AHA guideline for the management of patients with valvular heart disease. JACC. 
[21] Healthcare Financial Management Association (HFMA) / Published hospital chargemasters. [General reference for procedure costs] 

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