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Updated: Sep 17, 2025
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Interstitial lung abnormalities, coronary heart disease and mortality
Claire C Cutting1, Jonathan A Rose1, Ann-Marcia C Tukpah1
1Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Insights
Interstitial lung abnormalities (ILA) frequently co-occur with coronary heart disease (CHD) and are linked to increased mortality. This suggests ILA is a significant comorbidity in CHD patients, highlighting the need for integrated care approaches.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Epidemiology
Background:
- Interstitial lung abnormalities (ILA) share risk factors with coronary heart disease (CHD), such as aging and smoking.
- The association between ILA and CHD is not well-established.
- Understanding this relationship is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the relationship between ILA and CHD.
- To examine the association of ILA and CHD with mortality.
- To determine the clinical significance of ILA as a comorbidity in CHD.
Main Methods:
- Utilized data from the COPDGene and AGES-Reykjavik studies.
- Assessed ILA, clinical CHD, and coronary artery calcium (CAC).
- Employed logistic regression and Cox proportional hazards models to analyze associations.
Main Results:
- 9% of subjects with CHD had ILA in both cohorts.
- ILA was associated with increased odds of CHD (OR 1.6 in both cohorts).
- Participants with both ILA and CHD faced significantly higher mortality risk (HR 2.0 and 1.3) and increased odds of respiratory death (OR 9.6 in AGES-Reykjavik).
Conclusions:
- ILA commonly co-occurs with CHD.
- ILA is associated with worse mortality outcomes in patients with CHD.
- ILA represents a clinically significant comorbidity in the context of CHD.
Background:
Interstitial lung abnormalities (ILA) share common risk factors with coronary heart disease (CHD), including increased age and cigarette smoking; however, the relationship between ILA and CHD has not been well described.
Methods:
Participants from the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease study (COPDGene) and Age Gene/Environment Susceptibility (AGES)-Reykjavik studies with ILA assessment, clinical CHD and coronary artery calcium (CAC) data were included. In both cohorts, CHD was defined by clinical history and additionally by CAC >100. Multivariable logistic regression assessed the relationship between ILA and CHD; Cox proportional hazards models were used to assess mortality associated with ILA and CHD.
Results:
9% of participants with CHD had ILA in both COPDGene and AGES-Reykjavik. Participants with ILA had increased odds of CHD defined by clinical history in COPDGene (OR 1.6, 95% CI 1.2-2.0; p<0.001) and AGES-Reykjavik (OR 1.6, 95% CI 1.2-2.0; p<0.001); similar results were seen with CAC >100. In both COPDGene and AGES-Reykjavik, participants with both CHD and ILA had a greater risk of death compared to those with CHD but without ILA (HR 2.0, 95% CI 1.4-2.7; p<0.001; and HR 1.3, 95% CI 1.1-1.4; p<0.001, respectively). In AGES-Reykjavik, ILA was associated with an over 9-fold increase in the odds of a respiratory death (OR 9.6, 95% CI 3.2-29.0; p<0.0001) among participants with CHD.
Conclusion:
ILA are a common co-occurrence with CHD and associated with worse mortality, suggesting that ILA are a clinically important comorbidity in patients with CHD.
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