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| Home > Publications database > Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial. > print |
| 001 | 274082 | ||
| 005 | 20240229154925.0 | ||
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| 100 | 1 | _ | |a Mascalchi, Mario |0 P:(DE-He78)eba11eff7c9c475da132d5343d569759 |b 0 |e First author |u dkfz |
| 245 | _ | _ | |a Pulmonary emphysema and coronary artery calcifications at baseline LDCT and long-term mortality in smokers and former smokers of the ITALUNG screening trial. |
| 260 | _ | _ | |a Heidelberg |c 2023 |b Springer |
| 336 | 7 | _ | |a article |2 DRIVER |
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| 500 | _ | _ | |a #EA:C020# / 2023 May;33(5):3115-3123 |
| 520 | _ | _ | |a Cardiovascular disease (CVD), lung cancer (LC), and respiratory diseases are main causes of death in smokers and former smokers undergoing low-dose computed tomography (LDCT) for LC screening. We assessed whether quantification of pulmonary emphysematous changes at baseline LDCT has a predictive value concerning long-term mortality.In this longitudinal study, we assessed pulmonary emphysematous changes with densitometry (volume corrected relative area below - 950 Hounsfield units) and coronary artery calcifications (CAC) with a 0-3 visual scale in baseline LDCT of 524 participants in the ITALUNG trial and analyzed their association with mortality after 13.6 years of follow-up using conventional statistics and a machine learning approach.Pulmonary emphysematous changes were present in 32.3% of subjects and were mild (6% ≤ RA950 ≤ 9%) in 14.9% and moderate-severe (RA950 > 9%) in 17.4%. CAC were present in 67% of subjects (mild in 34.7%, moderate-severe in 32.2%). In the follow-up, 81 (15.4%) subjects died (20 of LC, 28 of other cancers, 15 of CVD, 4 of respiratory disease, and 14 of other conditions). After adjusting for age, sex, smoking history, and CAC, moderate-severe emphysema was significantly associated with overall (OR 2.22; 95CI 1.34-3.70) and CVD (OR 3.66; 95CI 1.21-11.04) mortality. Machine learning showed that RA950 was the best single feature predictive of overall and CVD mortality.Moderate-severe pulmonary emphysematous changes are an independent predictor of long-term overall and CVD mortality in subjects participating in LC screening and should be incorporated in the post-test calculation of the individual mortality risk profile.• Densitometry allows quantification of pulmonary emphysematous changes in low-dose CT examinations for lung cancer screening. • Emphysematous lung density changes are an independent predictor of long-term overall and cardio-vascular disease mortality in smokers and former smokers undergoing screening. • Emphysematous changes quantification should be included in the post-test calculation of the individual mortality risk profile. |
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| 650 | _ | 7 | |a Cardiovascular disease |2 Other |
| 650 | _ | 7 | |a Cause of death |2 Other |
| 650 | _ | 7 | |a Lung neoplasm |2 Other |
| 650 | _ | 7 | |a Pulmonary emphysema |2 Other |
| 650 | _ | 7 | |a Smokers |2 Other |
| 700 | 1 | _ | |a Romei, Chiara |b 1 |
| 700 | 1 | _ | |a Marzi, Chiara |b 2 |
| 700 | 1 | _ | |a Diciotti, Stefano |b 3 |
| 700 | 1 | _ | |a Picozzi, Giulia |b 4 |
| 700 | 1 | _ | |a Pistelli, Francesco |b 5 |
| 700 | 1 | _ | |a Zappa, Marco |b 6 |
| 700 | 1 | _ | |a Paci, Eugenio |b 7 |
| 700 | 1 | _ | |a Carozzi, Francesca |b 8 |
| 700 | 1 | _ | |a Gorini, Giuseppe |b 9 |
| 700 | 1 | _ | |a Falaschi, Fabio |b 10 |
| 700 | 1 | _ | |a Deliperi, Anna Lisa |b 11 |
| 700 | 1 | _ | |a Camiciottoli, Gianna |b 12 |
| 700 | 1 | _ | |a Carrozzi, Laura |b 13 |
| 700 | 1 | _ | |a Puliti, Donella |b 14 |
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