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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Friday, January 10, 2025
Screening for lung cancer using low-dose CT appears also to be effective at identifying coronary artery calcium—a strong risk factor for coronary artery disease—in patients without cardiac symptoms, according to research published in the Canadian Medical Association Journal. Gary R. Small, MB, BCh, BSc, PhD, MRCP, of the University of Ottawa Heart Institute, and colleagues found that coincidentally detected coronary artery calcium in extensive amounts was an independent predictor of all-cause death and cardiovascular events, even in the presence of cancer and other noncardiovascular deaths. The researchers suggested that attention to the prevention of cardiovascular disease may be combined with lung cancer screening initiatives.
“Lung cancer screening, although primarily geared towards reducing deaths from lung cancer, also has an opportunity to help tackle the second-most common cause of premature death in middle-aged adults, through the identification and risk stratification of coronary atherosclerosis,” said Dr. Small in a press release issued by the publisher.
A total of 1,486 patients who underwent CT screening for lung cancer between March 2017 and November 2018 as part of the Ontario Health Lung Cancer Screening Pilot for People at High Risk were included in the study. Coronary artery calcium was quantified using an estimated Agatston score (a summed value of all calcified coronary lesions), and the composite primary outcome of all-cause death and cardiovascular events was identified using linked electronic medical record data from The Ottawa Hospital.
The investigators reported that coronary artery calcium was detected in 82.9% of participants, and it was extensive in 29.5%. On multivariable analysis, they found that extensive coronary artery calcium was associated with the composite primary outcome (hazard ratio [HR] = 2.13; 95% confidence interval [CI] = 1.35–3.38), all-cause death (HR = 2.39; 95% CI = 1.34–4.27), and cardiovascular events (HR = 2.06; 95% CI = 1.13–3.77). It remained predictive of cardiovascular events after adjusting for noncardiovascular death as a competing risk (HR = 2.05; 95% CI = 1.09–3.85).
Disclosure: For full disclosures of the study authors, visit cmaj.ca.
Canadian Medical Association Journal
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