Coronary artery calcium is associated with long-term mortality from lung cancer: Results from the Coronary Artery Calcium Consortium

Autor: Leslee J. Shaw, Seamus P. Whelton, Martin Bødtker Mortensen, Khurram Nasir, Zeina Dardari, Alan Rozanski, Matthew J. Budoff, Michael J. Blaha, Philipp Berning, Omar Dzaye, Daniel S. Berman, Michael D. Miedema, John A. Rumberger
Rok vydání: 2021
Předmět:
Male
Aging
Lung Neoplasms
Heart disease
Coronary Artery Disease
Cardiorespiratory Medicine and Haematology
Cardiovascular
Coronary Angiography
Risk Factors
Cause of Death
Coronary arterial calcium
Lung
Early Detection of Cancer
Cancer
screening and diagnosis
Middle Aged
Cardiovascular disease
Coronary Vessels
Risk prediction
Detection
Coronary artery calcium
Heart Disease
medicine.anatomical_structure
cardiovascular system
Female
Lung cancer
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Clinical Sciences
Competing risks
Risk Assessment
Article
Clinical Research
Internal medicine
medicine
Humans
cardiovascular diseases
Vascular Calcification
Heart Disease - Coronary Heart Disease
Aged
business.industry
Prevention
medicine.disease
4.1 Discovery and preclinical testing of markers and technologies
Good Health and Well Being
Cardiovascular System & Hematology
Calcium
Long term mortality
business
Lung cancer screening
Zdroj: Atherosclerosis
Dzaye, O, Berning, P, Dardari, Z A, Berman, D S, Budoff, M J, Miedema, M D, Nasir, K, Rozanski, A, Rumberger, J A, Shaw, L J, Mortensen, M B, Whelton, S P & Blaha, M J 2021, ' Coronary artery calcium is associated with long-term mortality from lung cancer : Results from the Coronary Artery Calcium Consortium ', Atherosclerosis. Supplement, vol. 339, pp. 48-54 . https://doi.org/10.1016/j.atherosclerosis.2021.10.007
ISSN: 0021-9150
Popis: Background and aimsCoronary artery calcium (CAC) scores have been shown to be associated with CVD and cancer mortality. The use of CAC scores for overall and lung cancer mortality risk prediction for patients in the Coronary Artery Calcium Consortium was analyzed.MethodsWe included 55,943 patients aged 44-84 years without known heart disease from the CAC Consortium. There were 1,088 cancer deaths, among which 231 were lung cancer, identified by death certificates with a mean follow-up of 12.2±3.9 years. Fine-and-Gray competing-risk regression was used for overall and lung cancer-specific mortality, accounting for the competing risk of CVD death and after adjustment for CVD risk factors. Subdistribution hazard ratios (SHR) were reported.ResultsThe mean age of all patients was 57.1±8.6 years, 34.9% were women, and 89.6% were white. Overall, CAC was strongly associated with cancer mortality. Lung cancer mortality increased with increasing CAC scores, with rates per 1000-person years of 0.2 (95% CI: 0.1-0.3) for CAC=0 and 0.8 (95% CI: 0.6-1.0) for CAC ≥400. Compared with CAC=0, hazards were increased for those with CAC ≥400 for lung cancer mortality [SHR: 1.7 (95% CI: 1.2-2.6)], which was driven by women [SHR: 2.3 (95% CI: 1.1-4.8)], but not significantly increased for men. Risks were higher in those with positive smoking history [SHR: 2.2 (95% CI: 1.2-4.2)], with associations driven by women [SHR: 4.0 (95% CI: 1.4-11.5)].ConclusionsCAC scores were associated with increased risks for lung cancer mortality, with strongest associations for current and former smokers, especially in women. Used in conjunction with other clinical variables, our data pinpoint a potential synergistic use of CAC scanning beyond CVD risk assessment for identification of high-risk lung cancer screening candidates.
Databáze: OpenAIRE
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