ArticleAnnals of internal medicine2014
Association between emphysema-like lung on cardiac computed tomography and mortality in persons without airflow obstruction: a cohort study.
Article in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03026439 (The Boundaries of Mild Chronic Obstructive Pulmonary Disease), which is not on this map. Cited by 66 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Boundaries of Mild Chronic Obstructive Pulmonary Disease: Searching Clinical COPD Onset
Who cites it
66 citing papers in PubMed, 1 synthesis or guideline pooled it, 87 citations in OpenAlex.
- The Use of Computed Tomography Densitometry for the Assessment of Emphysema in Clinical Trials: A Position Paper from the Fleischner Society.American journal of respiratory and critical care medicine · 2025Pooled it
- Prevalence, Symptom Burden, and Underdiagnosis of Chronic Obstructive Pulmonary Disease in a Lung Cancer Screening Cohort.Annals of the American Thoracic Society · 2020Trial
- Association between Emphysema and Chronic Obstructive Pulmonary Disease Outcomes in the COPDGene and SPIROMICS Cohorts: A Post Hoc Analysis of Two Clinical Trials.American journal of respiratory and critical care medicine · 2018Trial
- From ideal respiratory health to chronic lung disease: indicators of impaired respiratory health.Expert review of respiratory medicine · 2026Review
- A self-supervised framework for emphysema anomaly detection and staging in computed tomography scans.Patterns (New York, N.Y.) · 2026Article
- Association between underdiagnosed and overdiagnosed chronic obstructive pulmonary disease with all-cause mortality.Journal of thoracic disease · 2025Article
- Article
- Article
- Lung structure and longitudinal change in cardiac structure and function: the MESA COPD Study.The European respiratory journal · 2024Article
- Update of prognosis and characteristics of chronic obstructive pulmonary disease in a real-world setting: a 5-year follow-up analysis of a multi-institutional registry.BMC pulmonary medicine · 2024Observational
- Indices of Childhood Socioeconomic Status and Dysanapsis among Older Adults: The Multi-Ethnic Study of Atherosclerosis Lung Study.Annals of the American Thoracic Society · 2024Article
- Article
- Clinical features and 1-year outcomes of chronic bronchitis in participants with normal spirometry: results from the ECOPD study in China.BMJ open respiratory research · 2023Article
- Lower respiratory illnesses in childhood are associated with the presence of air trapping in early adulthood.Respiratory medicine · 2023Article
- Centrilobular Emphysema Is Associated with Pectoralis Muscle Reduction in Current Smokers without Airflow Limitation.Respiration; international review of thoracic diseases · 2023Article
- Comparing Racial Differences in Emphysema Prevalence Among Adults With Normal Spirometry: A Secondary Data Analysis of the CARDIA Lung Study.Annals of internal medicine · 2022Observational
- Chest CT-assessed comorbidities and all-cause mortality risk in COPD patients in the BODE cohort.Respirology (Carlton, Vic.) · 2022Article
- Association between plasma sRAGE and emphysema according to the genotypes of AGER gene.BMC pulmonary medicine · 2022Article
- Observational
- Impaired Respiratory Health and Life Course Transitions From Health to Chronic Lung Disease.Chest · 2021Review
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundLow lung function is known to predict mortality in the general population, but the prognostic significance of emphysema on computed tomography (CT) in persons without chronic obstructive pulmonary disease (COPD) is uncertain.
objectiveTo determine whether greater emphysema-like lung on CT is associated with all-cause mortality among persons in the general population without airflow obstruction or COPD.
designProspective cohort study.
settingPopulation-based, multiethnic sample from 6 U.S. communities.
participants2965 participants aged 45 to 84 years without airflow obstruction on spirometry. MEASUREMENTS: Emphysema-like lung was defined as the number of lung voxels with attenuation less than -950 Hounsfield units on cardiac CT and was adjusted for the number of total imaged lung voxels.
resultsAmong 2965 participants, 50.9% of whom had never smoked, there were 186 deaths over a median of 6.2 years. Greater emphysema-like lung was independently associated with increased mortality (adjusted hazard ratio per one-half interquartile range, 1.14 [95% CI, 1.04 to 1.24]; P=0.004) after adjustment for potential confounders, including cardiovascular risk factors and FEV1. Generalized additive models supported a linear association between emphysema-like lung and mortality without evidence for a threshold. The association was of greatest magnitude among smokers, although multiplicative interaction terms did not support effect modification by smoking status. LIMITATIONS: Cardiac CT scans did not include lung apices. The number of deaths was limited among subgroup analyses.
conclusionEmphysema-like lung on CT was associated with all-cause mortality among persons without airflow obstruction or COPD in a general population sample, particularly among smokers. Recognition of the independent prognostic significance of emphysema on CT among patients without COPD on spirometry is warranted. PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.