Association of Coronary Artery Calcification and Mortality in the National Lung Screening Trial: A Comparison of Three Scoring Methods.
Association of Coronary Artery Calcification and Mortality in the National Lung Screening Trial: A Comparison of Three Scoring Methods.
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DOI：
10.1148/radiol.15142062
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发表时间：
2015-07
期刊：
影响因子：
19.7
通讯作者：
NLST Study Team
中科院分区：
文献类型：
--
作者：
Chiles C;Duan F;Gladish GW;Ravenel JG;Baginski SG;Snyder BS;DeMello S;Desjardins SS;Munden RF;NLST Study Team
评价三种冠状动脉钙化(CAC)评分方法在全国肺筛查试验(NLST)参与者中不同CAC评分水平下评估冠心病(CHD)死亡和全因死亡率的风险。NLST得到了每个参与机构的机构审查委员会的批准，并获得了所有参与者的知情同意。图像审查符合HIPAA标准。五位心胸放射科医生评估了来自三组的1575例低剂量计算机断层扫描(CT)扫描：210例冠心病死亡，315例非冠心病死亡，以及1050名试验结束时仍活着的参与者。放射科医生使用了三种评分方法：整体视觉评估、血管分段评分和阿加斯顿评分。加权COX比例风险模型适用于评估评分方法和结果之间的关联。在冠心病死亡时间的多因素分析中，Agatston评分1-100、101-1000和大于1000(参考类别0)与危险比分别为1.27(95%可信区间：0.69、2.53)、3.57(95%可信区间：2.14、7.48)和6.63(95%可信区间：3.57、14.97)；1-5、6-11和12-30(参考类别0)分段血管特异值之和的危险比分别为1.72(95%可信区间：1.05、3.34)、5.11(95%可信区间：2.92、10.94)和6.10(95%可信区间：3.19、14.05)；轻度、中度或重度(参考类别无)总体视觉评估的危险比分别为2.09(95%可信区间：1.30，4.16)、3.86(95%可信区间：2.02，8.20)和6.95(95%可信区间：3.73，15.67)。通过使用低剂量CT对老年、重度吸烟者进行肺癌筛查，可以对CAC进行简单的视觉评估，以评估冠心病死亡和全因死亡的风险，这与Agatston评分相当，并与预后密切相关。
To evaluate three coronary artery calcification (CAC) scoring methods to assess risk of coronary heart disease (CHD) death and all-cause mortality in National Lung Screening Trial (NLST) participants across levels of CAC scores. The NLST was approved by the institutional review board at each participating institution, and informed consent was obtained from all participants. Image review was HIPAA compliant. Five cardiothoracic radiologists evaluated 1575 low-dose computed tomographic (CT) scans from three groups: 210 CHD deaths, 315 deaths not from CHD, and 1050 participants who were alive at conclusion of the trial. Radiologists used three scoring methods: overall visual assessment, segmented vessel-specific scoring, and Agatston scoring. Weighted Cox proportional hazards models were fit to evaluate the association between scoring methods and outcomes. In multivariate analysis of time to CHD death, Agatston scores of 1–100, 101–1000, and greater than 1000 (reference category 0) were associated with hazard ratios of 1.27 (95% confidence interval: 0.69, 2.53), 3.57 (95% confidence interval: 2.14, 7.48), and 6.63 (95% confidence interval: 3.57, 14.97), respectively; hazard ratios for summed segmented vessel-specific scores of 1–5, 6–11, and 12–30 (reference category 0) were 1.72 (95% confidence interval: 1.05, 3.34), 5.11 (95% confidence interval: 2.92, 10.94), and 6.10 (95% confidence interval: 3.19, 14.05), respectively; and hazard ratios for overall visual assessment of mild, moderate, or heavy (reference category none) were 2.09 (95% confidence interval: 1.30, 4.16), 3.86 (95% confidence interval: 2.02, 8.20), and 6.95 (95% confidence interval: 3.73, 15.67), respectively. By using low-dose CT performed for lung cancer screening in older, heavy smokers, a simple visual assessment of CAC can be generated for risk assessment of CHD death and all-cause mortality, which is comparable to Agatston scoring and strongly associated with outcome.
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影响因子：
10.3
作者：
Aberle, Denise R.;Adams, Amanda M.;Pinsky, Paul F.
通讯作者：
Pinsky, Paul F.
影响因子：
39.2
作者：
Moyer, Virginia A.
通讯作者：
Moyer, Virginia A.
影响因子：
19.7
作者：
Sverzellati, Nicola;Cademartiri, Filippo;Pastorino, Ugo
通讯作者：
Pastorino, Ugo
影响因子：
3.6
作者：
Priola, Adriano M.;Priola, Sandro M.;Cardinale, Luciano
通讯作者：
Cardinale, Luciano
DOI：
10.1016/0735-1097(90)90282-t
发表时间：
1990-03-15
影响因子：
24
作者：
AGATSTON, AS;JANOWITZ, WR;DETRANO, R
通讯作者：
DETRANO, R