Abstract 11958: Coronary Artery Calcium is Associated With Increased Long-Term Mortality in Smokers Eligible for Lung Cancer Screening
Background: Lung cancer screening using low dose computed tomography (LDCT) is recommended for smokers aged between 55-80 years. Coronary artery calcium (CAC) is a frequent finding on LDCT, but its association with smoking and mortality in persons aged 55 and older is not well described. This study examined whether the presence of CAC could predict long-term mortality in a cohort of smokers who may be suitable for LDCT screening.
Methods: 4,143 adults aged 55 years and older (39% smokers) without known coronary artery disease underwent CAC testing and were followed for an average of 14.5 years. Multivariable Cox regression was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CI) for the primary endpoint of all-cause mortality.
Results: CAC was present in 52% of nonsmokers and 62% of smokers. Smokers with a CAC of zero had a 1.73 (95% CI = 1.20-2.50; p=0.003) adjusted risk of all-cause mortality compared to nonsmokers. Any presence of CAC further increased the adjusted risk of mortality in nonsmokers (HR 3.07, 95% CI = 2.32-4.07; p<0.001) and smokers (HR 4.67, 95% CI = 3.52-6.20; p<0.001). There appeared to be a dose-response relationship between increasing CAC severity and mortality risk.
Conclusions: Across nearly 15 years of follow-up, the presence of CAC remained strongly predictive of all-cause mortality in smokers aged 55 years and above, even in the absence of other cardiac risk factors. These findings propose a potential benefit in highlighting the presence of CAC when screening for lung cancer.
Author Disclosures: J. Schulman-Marcus: None. V. Valenti: None. B.Ó. Hartaigh: None. H. Gransar: None. Q. Truong: None. T.Q. Callister: None. L.J. Shaw: None. F.Y. Lin: None. J.K. Min: Other Research Support; Modest; GE Healthcare, Vital Images, Phillips Healthcare. Speakers Bureau; Modest; GE Healthcare. Consultant/Advisory Board; Modest; GE Healthcare, Arineta, Astra Zeneca, Bristol-Myers Squibb.
- © 2014 by American Heart Association, Inc.