OBJECTIVES: It remains unknown whether non-electrocardiogram-gated coronary artery calcium (CAC) score in lung cancer screening provides incremental prognostic value. The aim of this study was to evaluate the prognostic value of CAC in the Danish Lung Cancer Screening Trial (DLCST), in addition to conducting a systematic review and meta-analysis including previously published studies regarding CAC in lung cancer screening. DESIGN: In DLCST, we measured Agatston CAC scores in 1,945 current and former smokers. Causes of death were extracted from the Danish National Death Registry. We used Cox proportional hazards model to determine hazard ratios (HRs) of CAC scores. A weighted fixed-effects model was used for the meta-analysis. RESULTS: Median follow-up in DLCST was 7.1 years, and 55% were men. Overall survival rates associated with CAC scores of 0, 1-400, and > 400 were 98%, 96%, and 92% (p < 0.001), respectively. Adjusted HR of cardiovascular death associated with CAC >400 was 3.8 (1.0-15) (p < 0.05). The meta-analysis included 28,045 asymptomatic participants. A high non-gated CAC score was associated with fatal or non-fatal cardiovascular events (p < 0.0001). CONCLUSION: Assessment of non-electrocardiogram-gated CAC in lung cancer screening programs is a robust prognostic measure of fatal or non-fatal cardiovascular events in current and former smokers independent of traditional cardiovascular risk factors.
RCT Entities:
OBJECTIVES: It remains unknown whether non-electrocardiogram-gated coronary artery calcium (CAC) score in lung cancer screening provides incremental prognostic value. The aim of this study was to evaluate the prognostic value of CAC in the Danish Lung Cancer Screening Trial (DLCST), in addition to conducting a systematic review and meta-analysis including previously published studies regarding CAC in lung cancer screening. DESIGN: In DLCST, we measured Agatston CAC scores in 1,945 current and former smokers. Causes of death were extracted from the Danish National Death Registry. We used Cox proportional hazards model to determine hazard ratios (HRs) of CAC scores. A weighted fixed-effects model was used for the meta-analysis. RESULTS: Median follow-up in DLCST was 7.1 years, and 55% were men. Overall survival rates associated with CAC scores of 0, 1-400, and > 400 were 98%, 96%, and 92% (p < 0.001), respectively. Adjusted HR of cardiovascular death associated with CAC >400 was 3.8 (1.0-15) (p < 0.05). The meta-analysis included 28,045 asymptomatic participants. A high non-gated CAC score was associated with fatal or non-fatal cardiovascular events (p < 0.0001). CONCLUSION: Assessment of non-electrocardiogram-gated CAC in lung cancer screening programs is a robust prognostic measure of fatal or non-fatal cardiovascular events in current and former smokers independent of traditional cardiovascular risk factors.
Entities:
Keywords:
atherosclerosis; coronary artery calcium score; lung cancer screening; smoking
Authors: Katherine B Malcolm; Danya L Dinwoodey; Michael C Cundiff; Shawn M Regis; Andrea K Borondy Kitts; Christoph Wald; Miranda L Lynch; Wael Al-Husami; Andrea B McKee; Brady J McKee Journal: J Thorac Dis Date: 2018-05 Impact factor: 2.895
Authors: Giulia Veronesi; David R Baldwin; Claudia I Henschke; Simone Ghislandi; Sergio Iavicoli; Matthijs Oudkerk; Harry J De Koning; Joseph Shemesh; John K Field; Javier J Zulueta; Denis Horgan; Lucia Fiestas Navarrete; Maurizio Valentino Infante; Pierluigi Novellis; Rachael L Murray; Nir Peled; Cristiano Rampinelli; Gaetano Rocco; Witold Rzyman; Giorgio Vittorio Scagliotti; Martin C Tammemagi; Luca Bertolaccini; Natthaya Triphuridet; Rowena Yip; Alexia Rossi; Suresh Senan; Giuseppe Ferrante; Kate Brain; Carlijn van der Aalst; Lorenzo Bonomo; Dario Consonni; Jan P Van Meerbeeck; Patrick Maisonneuve; Silvia Novello; Anand Devaraj; Zaigham Saghir; Giuseppe Pelosi Journal: Cancers (Basel) Date: 2020-06-24 Impact factor: 6.639
Authors: Mamta Ruparel; Samantha L Quaife; Jennifer L Dickson; Carolyn Horst; Stephen Burke; Magali Taylor; Asia Ahmed; Penny Shaw; May-Jan Soo; Arjun Nair; Anand Devaraj; Emma Louise O'Dowd; Angshu Bhowmik; Neal Navani; Karen Sennett; Stephen W Duffy; David R Baldwin; Reecha Sofat; Riyaz S Patel; Aroon Hingorani; Sam M Janes Journal: Thorax Date: 2019-09-26 Impact factor: 9.102
Authors: Maren E Shipe; Amelia W Maiga; Stephen A Deppen; Gretchen C Edwards; Hannah N Marmor; Rhonda Pinkerman; Gary T Smith; Elizabeth Lio; Johnny L Wright; Chirayu Shah; Jonathan C Nesbitt; Eric L Grogan Journal: J Thorac Dis Date: 2021-03 Impact factor: 2.895
Authors: Paul Leong; Martin I MacDonald; Paul T King; Christian R Osadnik; Brian S Ko; Shane A Landry; Kais Hamza; Ahilan Kugenasan; John M Troupis; Philip G Bardin Journal: ERJ Open Res Date: 2021-02-08