Coronary Artery Calcification on Computed Tomography Correlates With Mortality in Chronic Obstructive Pulmonary Disease
Coronary Artery Calcification on Computed Tomography Correlates With Mortality in Chronic Obstructive Pulmonary Disease
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DOI：
10.1097/rct.0000000000000119
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发表时间：
2014-09-01
影响因子：
1.3
通讯作者：
Yang, Ian A.
中科院分区：
文献类型：
--
作者：
O'Hare, Phoebe E.;Ayres, Jonny F.;Yang, Ian A.
目的：这项横断面研究评估了计算机断层扫描 (CT) 冠状动脉钙化 (CAC)（与肺气肿无关）对慢性阻塞性肺疾病 (COPD) 患者的预后影响。材料和方法：使用经过验证的 CAC 序数视觉量表（CAC OVS；范围，0-12）和视觉 CT，对 COPD 患者进行非造影、非门控胸部 CT 扫描，评估冠状动脉钙化和肺气肿。肺气肿指数。结果：总共分析了200张CT图像。全因死亡率与 CAC OVS 大于 4（风险比，2.03；95% 置信区间，1.08-3.82；P = 0.028）以及中度至重度 CT 肺气肿指数相关（风险比，4.34；95% 置信区间，1.53-12.33；P = 0.006）。肺气肿严重程度增加、心肌梗死、高血压和男性与 CAC OVS 大于 4 独立相关。结论：CT 图像上的冠状动脉钙化严重程度和肺气肿严重程度与中重度 COPD 患者的预后相关，并且与预后强相关和独立相关。在非增强非门控 CT 上使用 CAC OVS 作为冠状动脉疾病筛查工具和 COPD 患者预后标志物的潜力需要在前瞻性研究中进一步研究。
Objective: This cross-sectional study assessed the prognostic implications of computed tomography (CT) coronary artery calcification (CAC), independent of emphysema, in patients with chronic obstructive pulmonary disease (COPD).Materials and Methods: Coronary artery calcification and emphysema were assessed on noncontrast, ungated chest CT scans of patients with COPD using the validated CAC ordinal visual scale (CAC OVS; range, 0-12) and visual CT emphysema index.Results: A total of 200 CT images were analyzed. All-cause mortality was associated with CAC OVS greater than 4 (hazard ratio, 2.03; 95% confidence interval, 1.08-3.82; P = 0.028) and with moderate to severe CT emphysema index (hazard ratio, 4.34; 95% confidence interval, 1.53-12.33; P = 0.006). Increased emphysema severity, myocardial infarction, hypertension, and male sex independently correlated with CAC OVS greater than 4.Conclusions: Coronary artery calcification severity and emphysema severity on CT images are related and are strongly as well as independently associated with prognosis in patients with moderate to severe COPD. The potential to use CAC OVS on unenhanced nongated CTas a screening tool for coronary artery disease and as a prognostic marker in patients with COPD needs further investigation in prospective studies.