Qualitative coronary artery calcification scores and risk of all cause, COPD and pneumonia hospital admission in a large CT lung cancer screening cohort. (September 2021)

• Record Type: Journal Article
• Authors: Gazourian, Lee; Regis, Shawn M.; Pagura, Elizabeth J.; Price, Lori Lyn; Gawlik, Melissa; Lamb, Carla; Rieger-Christ, Kimberly M.; Thedinger, William B.; Sanayei, Ava M.; Long, William P.; Stefanescu, Cristina F.; Rizzo, Giulia S.; Patel, Avignat S.; Come, Carolyn E.; Thomson, Carey C.; Pinto-Plata, Victor; Steiling, Katrina; McKee, Andrea B.; Wald, Christoph; McKee, Brady J.; Liesching, Timothy N.
• Is Part Of: Respiratory medicine. Volume 186(2021)
• Publication Date: 2021-09
• Subjects: Lung cancer screening -- COPD -- Pneumonia -- Coronary artery calcification; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106540
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Patients at high-risk for lung cancer and qualified for CT lung cancer screening (CTLS) are at risk for numerous cardio-pulmonary comorbidities. We sought to examine if qualitatively assessed coronary artery calcifications (CAC) on CTLS exams could identify patients at increased risk for non-cardiovascular events such as all cause, COPD and pneumonia related hospitalization and to verify previously reported associations between CAC and mortality and cardiovascular events. Study design and methods: Patients (n = 4673) from Lahey Hospital and Medical Center who underwent CTLS from January 12, 2012 through September 30, 2017 were included with clinical follow-up through September 30, 2019. CTLS exams were qualitatively scored for the presence and severity of CAC at the time of exam interpretation using a four point scale: none, mild, moderate, and marked. Multivariable Cox regression models were used to evaluate the association between CT qualitative CAC and all-cause, COPD-related, and pneumonia-related hospital admissions. Results: 3631 (78%) of individuals undergoing CTLS had some degree of CAC on their baseline exam: 1308 (28.0%), 1128 (24.1%), and 1195 (25.6%) had mild, moderate and marked coronary calcification, respectively. Marked CAC was associated with all-cause hospital admission and pneumonia related admissions HR 1.48; 95% CI 1.23–1.78 and HR 2.19; 95% 1.30–3.71, respectively. Mild, moderate and marked CAC were associated with COPD-related admission HR 2.30; 95% CI 1.31–4.03, HR 2.17; 95% CI 1.20–3.91 and HR 2.27; 95% CI 1.24–4.15. Conclusion: Qualitative CAC on CTLS exams identifies individuals at elevated risk for all cause, pneumonia and COPD-related hospital admissions.