ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2024
Prognostic importance of extensive coronary calcium on lung cancer screening chest computed tomography.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Lung Cancer Screening and Prevention: Beyond Conventional Strategies in a Rapidly Changing Global Milieu.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2026Review
- Coronary artery calcium on lung cancer screening-CT: An opportunity to optimize cardiovascular disease risk reduction.International journal of cardiology. Heart & vasculature · 2025Article
- Early detection of cardiovascular disease in chest population screening: challenges for a rapidly emerging cardiac CT application.The British journal of radiology · 2025Review
- Calcium Hides the Clue: Unraveling the Diagnostic Value of Coronary Calcium Scoring in Cardiac Arrest Survivors.Journal of personalized medicine · 2025Article
- [Influence of artificial intelligence on decisions in radiology using the example of lung cancer screening].Radiologie (Heidelberg, Germany) · 2025Article
- Correction to "Nomenclature revision may mitigate potential overtreatment of incidental finding of coronary calcium on chest computed tomography".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Nomenclature revision may mitigate potential overtreatment of incidental finding of coronary calcium on chest computed tomography.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundLow-dose chest computed tomography (CT) is used for lung cancer screening, but can also detect coronary artery disease as coronary artery calcium. We sought to determine the prevalence and prognostic utility of coronary artery calcium in a population at high risk of cancer.
methodsWe reviewed CT scans from consecutive participants screened for lung cancer between March 2017 and November 2018 as part of the Ontario Health Lung Cancer Screening Pilot for People at High Risk. We quantified coronary artery calcium using an estimated Agatston score. We identified the composite primary outcome of all-cause death and cardiovascular events using linked electronic medical record data from The Ottawa Hospital to December 2023.
resultsAmong 1486 people who underwent screening CT, coronary artery calcium was detected in 1232 (82.9%) and was extensive in 439 (29.5%). On multivariable analysis, extensive coronary artery calcium was associated with the composite primary outcome (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.35-3.38), all-cause death (HR 2.39, 95% CI 1.34-4.27), and cardiovascular events (HR 2.06, 95% CI 1.13-3.77). Extensive coronary artery calcium remained predictive of cardiovascular events after we adjusted for noncardiovascular death as a competing risk (HR 2.05, 95% CI 1.09-3.85).
interpretationAmong people undergoing low-dose chest CT for lung cancer screening, extensive coronary artery calcium was an independent predictor of all-cause death and cardiovascular events, even after adjustment for noncardiovascular death. The opportunity to identify and reduce risks from coronary artery disease may represent an additional benefit of lung cancer screening.
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