Coronary artery calcification in lung cancer screening

Abstract

Lung cancer screening has been shown in the National Lung Screening Trial (NLST) to result in a statistically significant decrease in lung cancer specific mortality. Also within that trial there was shown to be a 7% decrease in all-cause mortality. While the reasons for this benefit are not entirely clear, it may relate to the detection and treatment of other important findings. Smokers not only have a higher risk of lung cancer, but also increased risk of atherosclerosis. The latter can be detected by the discovery of aortic and/or coronary artery calcium on unenhanced CT. As coronary artery calcium scoring can be used as a screening tool to detect asymptomatic coronary artery atherosclerosis, its detection on lung cancer screening exams has the potential to provide both a teachable moment and treatment aimed at the reduction of major coronary artery events and mortality. In this review we will discuss the use of coronary artery calcium scoring for the detection of atherosclerotic disease and its potential application to lung cancer screening populations.

Impacts of Coronary Artery Calcification on Intradialytic Blood Pressure Patterns in Patients Receiving Maintenance Hemodialysis

“…20,21 Furthermore CACS obtained from nongated CT scans for lung cancer screening has been demonstrated as a valuable biomarker in diagnosis and risk prediction for coronary heart disease. 31 In conclusion, we investigated the impact of coronary artery calcification on intradialytic BP patterns in patients with ESRD on maintenance hemodialysis. CACS measured using nongated chest CT scans was associated with widened pulse pressure, but was not related to either intradialytic hypotension or hypertension.…”

Conventional Computed Tomographic Calcium Scoring vs Full Chest CTCS for Lung Cancer Screening: A Cost-Effectiveness Analysis

“…NLST data have shown that the presence of coronary artery calcification is associated with a 3 fold increase in cardiovascular death 12 . These studies suggest a concordance of CAD and lung cancer [11][12][13] . Therefore, adding patients who are receiving CTCS to a lung cancer screening cohort is reasonable on several levels.…”

“…The ASCVD risk is calculated based on age, sex, race, smoking status, blood pressure, cholesterol levels, smoking status and diabetic status 2 . Atherosclerotic cardiovascular disease shared risk factors with lung cancer which could explain the benefit of performing FCT on this population [11][12][13] . We concede that as tobacco rates decrease, the malignancy rate in IPN will also decrease, thereby erasing the benefit of FCT.…”

“…This study suggests that there is benefit to lung cancer screening in other populations as well. Coronary artery calcification is frequently identified in patients undergoing lung cancer screening with LDCT [11][12][13] . NLST data have shown that the presence of coronary artery calcification is associated with a 3 fold increase in cardiovascular death 12 .…”

Conventional Computed Tomographic Calcium Scoring vs Full Chest CTCS for Lung Cancer Screening: A Cost-Effectiveness Analysis

“…This study suggests that there is benefit to lung cancer screening in other populations as well. Coronary artery calcification is frequently identified in patients undergoing lung cancer screening with LDCT [12][13][14] . NLST data have shown that the presence of coronary artery calcification is associated with a 3 fold increase in cardiovascular death 13 .…”