Coronary artery calcification and emphysema

Abstract

It is thought that emphysema patients are at a higher risk of coronary artery disease. The present study is one of very few that evaluated the prevalence of significant coronary artery disease in emphysema patients using coronary artery calcification measured by electron beam computed tomography. A retrospective chart review evaluated 1720 consecutive patients, some of whom were self-referred. All patients had both heart and lungs imaged with electron beam computed tomography when they were seen at the Inner Imaging Center, a cardiac imaging center affiliated with the Beth Israel Hospital in New York, New York. Multiple logistic regression was performed to determine which factors were independently associated with coronary artery calcification. Age, sex, hypertension and smoking were the risk factors independently associated with coronary artery calcification in the population studied. The emphysema group was significantly higher on measures of smoking and hypertension compared with the control group. Comparison of scores between the two groups using different categories for coronary artery calcification scores did not show a statistically significant difference using chi(2) analysis (P=0.088). However, there was a significant difference between dichotomized coronary artery calcification scores of lower than 100 and 100 or higher in patients with and without emphysema, respectively (P=0.013). Coexisting smoking and hypertension may contribute to the higher incidence of coronary artery calcification in emphysema patients. Symptoms of chest pain and shortness of breath were not different between the emphysema and control groups. Emphysema patients have a higher prevalence of significant coronary artery calcification, defined as a coronary artery calcification score higher than 100.