Coronary artery calcification on computed tomography correlates with mortality in chronic obstructive pulmonary disease

Area of Science:

• Cardiology
• Pulmonology
• Radiology

Background:

• Chronic obstructive pulmonary disease (COPD) is associated with increased cardiovascular risk.
• Assessing cardiovascular risk in COPD patients using non-invasive imaging is crucial for prognosis.

Purpose of the Study:

• To evaluate the prognostic significance of computed tomography (CT) coronary artery calcification (CAC) in patients with COPD, independent of emphysema.
• To explore the relationship between CAC severity and emphysema severity on CT scans.

Main Methods:

• Cross-sectional analysis of 200 noncontrast, ungated chest CT scans from COPD patients.
• Assessment of CAC using the validated CAC ordinal visual scale (CAC OVS) and emphysema using the visual CT emphysema index.

Main Results:

• Higher CAC OVS (>4) was associated with increased all-cause mortality (HR 2.03).
• Moderate to severe emphysema index also predicted mortality (HR 4.34).
• Emphysema severity, myocardial infarction, hypertension, and male sex independently correlated with CAC OVS >4.

Conclusions:

• Both CAC and emphysema severity on CT are independently associated with prognosis in moderate to severe COPD.
• CAC OVS on unenhanced, ungated CT shows potential as a screening tool for coronary artery disease and a prognostic marker in COPD patients.
• Further prospective studies are needed to confirm the utility of CAC OVS in COPD management.