Coronary artery calcification detected on low-dose computed tomography in high-risk participants of an Australian lung cancer screening program: A prospective observational study.

Autor:	Bonney A; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Chua M; Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., McCusker MW; Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Radiology, University of Melbourne, Melbourne, Victoria, Australia., Pascoe D; Department of Radiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.; Department of Radiology, University of Melbourne, Melbourne, Victoria, Australia., Joshi SB; Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Steinfort D; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Marshall H; Thoracic Research Centre, University of Queensland, Chermside, Queensland, Australia.; Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia., Silver JD; Statistical Consulting Centre, School of Mathematics and Statistics, University of Melbourne, Melbourne, Victoria, Australia., Xie C; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Yang S; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Watson J; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia., Fogarty P; Respiratory Department, Epworth Eastern Hospital, Box Hill, Victoria, Australia., Stone E; Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.; University of New South Wales, School of Clinical Medicine, St Vincent's Clinical School; School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia., Brims F; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.; Curtin Medical School, Curtin University, Bentley, Western Australia, Australia.; National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Nedlands, Western Australia, Australia., McWilliams A; Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.; Department of Medicine, University of Western Australia, Nedlands, Western Australia, Australia., Hu X; Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital, Darlinghurst, New South Wales, Australia., Rofe C; Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital, Darlinghurst, New South Wales, Australia., Milner B; Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital, Darlinghurst, New South Wales, Australia., Lam S; Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada., Fong KM; Thoracic Research Centre, University of Queensland, Chermside, Queensland, Australia.; Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia., Manser R; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.; Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	Respirology (Carlton, Vic.) [Respirology] 2024 Sep 24. Date of Electronic Publication: 2024 Sep 24.
DOI:	10.1111/resp.14832
Abstrakt:	Background and Objectives: Coronary artery calcification (CAC) is a frequent additional finding on lung cancer screening (LCS) low-dose computed tomography (LDCT). Cardiovascular disease (CVD) is a major cause of death in LCS participants. We aimed to describe prevalence of incidental CAC detected on LDCT in LCS participants without prior history of coronary artery disease (CAD), evaluate their CVD risk and describe subsequent investigation and management. Methods: Prospective observational nested cohort study including all participants enrolled at a single Australian site of the International Lung Screen Trial. Baseline LDCTs were reviewed for CAC, and subsequent information collected regarding cardiovascular health. 5-year CVD risk was calculated using the AusCVD risk calculator. Results: 55% (226/408) of participants had CAC on LDCT and no prior history of CAD, including 23% with moderate-severe CAC. Mean age of participants with CAC was 65 years, 68% were male. 53% were currently smoking. Majority were high risk (51%) or intermediate risk (32%) of a cardiovascular event in 5 years. 21% of participants were re-stratified to a higher CVD risk group when CAC detected on LCS was incorporated. Only 10% of participants with CAC received lifestyle advice (only 3% currently smoking received smoking cessation advice). 80% of participants at high-risk did not meet guideline recommendations, with 47% of this group remaining without cholesterol lowering therapy. Conclusion: LCS with LDCT offers the potential to identify and communicate CVD risk in this population. This may improve health outcomes for high-risk LCS participants and further personalize management once screening results are known. (© 2024 The Author(s). Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.)
Databáze:	MEDLINE
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