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Evaluation of cardiovascular risk in a lung cancer screening cohort
INTRODUCTION: Lung cancer screening (LCS) by low-dose computed tomography (LDCT) offers an opportunity to impact both lung cancer and coronary heart disease mortality through detection of coronary artery calcification (CAC). Here, we explore the value of CAC and cardiovascular disease (CVD) risk ass...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902068/ https://www.ncbi.nlm.nih.gov/pubmed/31558626 http://dx.doi.org/10.1136/thoraxjnl-2018-212812 |
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author | Ruparel, Mamta Quaife, Samantha L Dickson, Jennifer L Horst, Carolyn Burke, Stephen Taylor, Magali Ahmed, Asia Shaw, Penny Soo, May-Jan Nair, Arjun Devaraj, Anand O'Dowd, Emma Louise Bhowmik, Angshu Navani, Neal Sennett, Karen Duffy, Stephen W Baldwin, David R Sofat, Reecha Patel, Riyaz S Hingorani, Aroon Janes, Sam M |
author_facet | Ruparel, Mamta Quaife, Samantha L Dickson, Jennifer L Horst, Carolyn Burke, Stephen Taylor, Magali Ahmed, Asia Shaw, Penny Soo, May-Jan Nair, Arjun Devaraj, Anand O'Dowd, Emma Louise Bhowmik, Angshu Navani, Neal Sennett, Karen Duffy, Stephen W Baldwin, David R Sofat, Reecha Patel, Riyaz S Hingorani, Aroon Janes, Sam M |
author_sort | Ruparel, Mamta |
collection | PubMed |
description | INTRODUCTION: Lung cancer screening (LCS) by low-dose computed tomography (LDCT) offers an opportunity to impact both lung cancer and coronary heart disease mortality through detection of coronary artery calcification (CAC). Here, we explore the value of CAC and cardiovascular disease (CVD) risk assessment in LCS participants in the Lung Screen Uptake Trial (LSUT). METHODS: In this cross-sectional study, current and ex-smokers aged 60–75 were invited to a ‘lung health check’. Data collection included a CVD risk assessment enabling estimation of 10 year CVD risk using the QRISK2 score. Participants meeting the required lung cancer risk underwent an ungated, non-contrast LDCT. Descriptive data, bivariate associations and a multivariate analysis of predictors of statin use are presented. RESULTS: Of 1005 individuals enrolled, 680 were included in the final analysis. 421 (61.9%) had CAC present and in 49 (7.2%), this was heavy. 668 (98%) of participants had a QRISK2≥10% and QRISK2 was positively associated with increasing CAC grade (OR 4.29 (CI 0.93 to 19.88) for QRISK2=10%–20% and 12.29 (CI 2.68 to 56.1) for QRISK2≥20% respectively). Of those who qualified for statin primary prevention (QRISK2≥10%), 56.8% did not report a history of statin use. In the multivariate analysis statin use was associated with age, body mass index and history of hypertension and diabetes. CONCLUSIONS: LCS offers an important opportunity for instituting CVD risk assessment in all LCS participants irrespective of the presence of LDCT-detected CAC. Further studies are needed to determine whether CAC could enhance uptake and adherence to primary preventative strategies. |
format | Online Article Text |
id | pubmed-6902068 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-69020682019-12-24 Evaluation of cardiovascular risk in a lung cancer screening cohort Ruparel, Mamta Quaife, Samantha L Dickson, Jennifer L Horst, Carolyn Burke, Stephen Taylor, Magali Ahmed, Asia Shaw, Penny Soo, May-Jan Nair, Arjun Devaraj, Anand O'Dowd, Emma Louise Bhowmik, Angshu Navani, Neal Sennett, Karen Duffy, Stephen W Baldwin, David R Sofat, Reecha Patel, Riyaz S Hingorani, Aroon Janes, Sam M Thorax Lung Cancer INTRODUCTION: Lung cancer screening (LCS) by low-dose computed tomography (LDCT) offers an opportunity to impact both lung cancer and coronary heart disease mortality through detection of coronary artery calcification (CAC). Here, we explore the value of CAC and cardiovascular disease (CVD) risk assessment in LCS participants in the Lung Screen Uptake Trial (LSUT). METHODS: In this cross-sectional study, current and ex-smokers aged 60–75 were invited to a ‘lung health check’. Data collection included a CVD risk assessment enabling estimation of 10 year CVD risk using the QRISK2 score. Participants meeting the required lung cancer risk underwent an ungated, non-contrast LDCT. Descriptive data, bivariate associations and a multivariate analysis of predictors of statin use are presented. RESULTS: Of 1005 individuals enrolled, 680 were included in the final analysis. 421 (61.9%) had CAC present and in 49 (7.2%), this was heavy. 668 (98%) of participants had a QRISK2≥10% and QRISK2 was positively associated with increasing CAC grade (OR 4.29 (CI 0.93 to 19.88) for QRISK2=10%–20% and 12.29 (CI 2.68 to 56.1) for QRISK2≥20% respectively). Of those who qualified for statin primary prevention (QRISK2≥10%), 56.8% did not report a history of statin use. In the multivariate analysis statin use was associated with age, body mass index and history of hypertension and diabetes. CONCLUSIONS: LCS offers an important opportunity for instituting CVD risk assessment in all LCS participants irrespective of the presence of LDCT-detected CAC. Further studies are needed to determine whether CAC could enhance uptake and adherence to primary preventative strategies. BMJ Publishing Group 2019-12 2019-09-26 /pmc/articles/PMC6902068/ /pubmed/31558626 http://dx.doi.org/10.1136/thoraxjnl-2018-212812 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Lung Cancer Ruparel, Mamta Quaife, Samantha L Dickson, Jennifer L Horst, Carolyn Burke, Stephen Taylor, Magali Ahmed, Asia Shaw, Penny Soo, May-Jan Nair, Arjun Devaraj, Anand O'Dowd, Emma Louise Bhowmik, Angshu Navani, Neal Sennett, Karen Duffy, Stephen W Baldwin, David R Sofat, Reecha Patel, Riyaz S Hingorani, Aroon Janes, Sam M Evaluation of cardiovascular risk in a lung cancer screening cohort |
title | Evaluation of cardiovascular risk in a lung cancer screening cohort |
title_full | Evaluation of cardiovascular risk in a lung cancer screening cohort |
title_fullStr | Evaluation of cardiovascular risk in a lung cancer screening cohort |
title_full_unstemmed | Evaluation of cardiovascular risk in a lung cancer screening cohort |
title_short | Evaluation of cardiovascular risk in a lung cancer screening cohort |
title_sort | evaluation of cardiovascular risk in a lung cancer screening cohort |
topic | Lung Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902068/ https://www.ncbi.nlm.nih.gov/pubmed/31558626 http://dx.doi.org/10.1136/thoraxjnl-2018-212812 |
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