Qualitative coronary artery calcification scores and risk of all cause, COPD and pneumonia hospital admission in a large CT lung cancer screening cohort
Author Department
Pulmonary/Critical Care Medicine; Medicine
Document Type
Article, Peer-reviewed
Publication Date
7-2021
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.
Keywords: COPD; Coronary artery calcification; Lung cancer screening; Pneumonia.
Recommended Citation
Gazourian L, Regis SM, Pagura EJ, Price LL, Gawlik M, Lamb C, Rieger-Christ KM, Thedinger WB, Sanayei AM, Long WP, Stefanescu CF, Rizzo GS, Patel AS, Come CE, Thomson CC, Pinto-Plata V, Steiling K, McKee AB, Wald C, McKee BJ, Liesching TN. Qualitative coronary artery calcification scores and risk of all cause, COPD and pneumonia hospital admission in a large CT lung cancer screening cohort. Respir Med. 2021 Jul 12;186:106540. doi: 10.1016/j.rmed.2021.106540. Epub ahead of print.
PMID
34311389