Format

Send to

Choose Destination
Chest. 2018 Sep;154(3):579-587. doi: 10.1016/j.chest.2018.05.037. Epub 2018 Jun 8.

Visual Estimate of Coronary Artery Calcium Predicts Cardiovascular Disease in COPD.

Author information

1
Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL; UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL. Electronic address: sbhatt@uabmc.edu.
2
Department of Radiology, University of Michigan, Ann Arbor, MI.
3
Department of Radiology, University of Iowa, Iowa City, IA.
4
Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO.
5
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA.
6
Department of Radiology, Temple University Hospital, Philadelphia, PA.
7
Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.
8
Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL; UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL.
9
Department of Radiology, Brigham and Women's Hospital, Boston, MA.
10
Department of Radiology, University of California at San Diego, San Diego, CA.
11
Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL; UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, AL; UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL; Birmingham VA Medical Center, Birmingham, AL.
12
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
13
UAB Lung Imaging Core, University of Alabama at Birmingham, Birmingham, AL; Department of Radiology, University of Alabama at Birmingham, Birmingham, AL.

Abstract

BACKGROUND:

COPD is associated with cardiovascular disease (CVD), and coronary artery calcification (CAC) provides additional prognostic information. With increasing use of nongated CT scans in clinical practice, this study hypothesized that the visual Weston CAC score would perform as well as the Agatston score in predicting prevalent and incident coronary artery disease (CAD) and CVD in COPD.

METHODS:

CAC was measured by using Agatston and Weston scores on baseline CT scans in 1,875 current and former smokers enrolled in the Genetic Epidemiology of COPD (COPDGene) study. Baseline cardiovascular disease and incident cardiac events on longitudinal follow-up were recorded. Accuracy of the CAC scores was measured by using receiver-operating characteristic analysis, and Cox proportional hazards analyses were used to estimate the risk of incident cardiac events.

RESULTS:

CAD was reported by 133 (7.1%) subjects at baseline. A total of 413 (22.0%) and 241 (12.9%) patients had significant CAC according to the Weston (≥ 7) and Agatston (≥ 400) scores, respectively; the two methods were significantly correlated (r = 0.84; P < .001). Over 5 years of follow-up, 127 patients (6.8%) developed incident CVD. For predicting prevalent CAD, c-indices for the Weston and Agatston scores were 0.78 and 0.74 and for predicting incident CVD, they were 0.62 and 0.61. After adjustment for age, race, sex, smoking pack-years, FEV1, percent emphysema, and CT scanner type, a Weston score ≥ 7 was associated with time to first acute coronary event (hazard ratio, 2.16 [95% CI, 1.32 to 3.53]; P = .002), but a Agatston score ≥ 400 was not (hazard ratio, 1.75 [95% CI, 0.99-3.09]; P = .053).

CONCLUSIONS:

A simple visual score for CAC performed well in predicting incident CAD in smokers with and without COPD.

TRIAL REGISTRY:

ClinicalTrials.gov; No.: NCT00608764; URL: www.clinicaltrials.gov.

KEYWORDS:

COPD; cardiovascular disease; coronary calcification

PMID:
29890123
PMCID:
PMC6130328
[Available on 2019-09-01]
DOI:
10.1016/j.chest.2018.05.037
Free full text

Supplemental Content

Full text links

Icon for Elsevier Science Icon for eScholarship, California Digital Library, University of California
Loading ...
Support Center