A Longitudinal Cohort Study of Aspirin Use and Progression of Emphysema-like Lung Characteristics on CT Imaging: The MESA Lung Study

Carrie P Aaron; Joseph E Schwartz; Eric A Hoffman; Elsa Angelini; John H M Austin; Mary Cushman; David R Jacobs Jr; Joel D Kaufman; Andrew Laine; Lewis J Smith; Jie Yang; Karol E Watson; Russell P Tracy; R Graham Barr

doi:10.1016/j.chest.2017.11.031

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A Longitudinal Cohort Study of Aspirin Use and Progression of Emphysema-like Lung Characteristics on CT Imaging: The MESA Lung Study

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A Longitudinal Cohort Study of Aspirin Use and Progression of Emphysema-like Lung Characteristics on CT Imaging: The MESA Lung Study

Carrie P Aaron, Joseph E Schwartz, Eric A Hoffman, Elsa Angelini, John H M Austin, Mary Cushman, David R Jacobs Jr, Joel D Kaufman, Andrew Laine, Lewis J Smith, …

Chest, Vol.154(1), pp.41-50

07/2018

DOI: 10.1016/j.chest.2017.11.031

PMCID: PMC6045779

PMID: 29246770

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Abstract

Platelet activation reduces pulmonary microvascular blood flow and contributes to inflammation; these factors have been implicated in the pathogenesis of COPD and emphysema. We hypothesized that regular use of aspirin, a platelet inhibitor, would be associated with a slower progression of emphysema-like lung characteristics on CT imaging and a slower decline in lung function. The Multi-Ethnic Study of Atherosclerosis (MESA) enrolled participants 45 to 84 years of age without clinical cardiovascular disease from 2000 to 2002. The MESA Lung Study assessed the percentage of emphysema-like lung below -950 Hounsfield units ("percent emphysema") on cardiac (2000-2007) and full-lung CT scans (2010-2012). Regular aspirin use was defined as 3 or more days per week. Mixed-effect models adjusted for demographics, anthropometric features, smoking, hypertension, angiotensin-converting enzyme inhibitor or angiotensin II-receptor blocker use, C-reactive protein levels, sphingomyelin levels, and scanner factors. At baseline, the 4,257 participants' mean (± SD) age was 61 ± 10 years, 54% were ever smokers, and 22% used aspirin regularly. On average, percent emphysema increased 0.60 percentage points over 10 years (95% CI, 0.35-0.94). Progression of percent emphysema was slower among regular aspirin users compared with patients who did not use aspirin (fully adjusted model: -0.34% /10 years, 95% CI, -0.60 to -0.08; P = .01). Results were similar in ever smokers and with doses of 81 and 300 to 325 mg and were of greater magnitude among those with airflow limitation. No association was found between aspirin use and change in lung function. Regular aspirin use was associated with a more than 50% reduction in the rate of emphysema progression over 10 years. Further study of aspirin and platelets in emphysema may be warranted.

Pulmonary Emphysema - ethnology

United States - epidemiology

Pulmonary Emphysema - diagnosis

Prognosis

Prospective Studies

Follow-Up Studies

Humans

Middle Aged

Cyclooxygenase Inhibitors - administration & dosage

Tomography, X-Ray Computed - methods

Male

Pulmonary Emphysema - drug therapy

Lung - diagnostic imaging

Lung - physiopathology

Disease Progression

Aspirin - administration & dosage

Incidence

Dose-Response Relationship, Drug

Ethnic Groups

Aged, 80 and over

Female

Aged

Details

Title: Subtitle: A Longitudinal Cohort Study of Aspirin Use and Progression of Emphysema-like Lung Characteristics on CT Imaging: The MESA Lung Study
Creators: Carrie P Aaron - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY. Electronic address: cp2346@columbia.edu
Joseph E Schwartz - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
Eric A Hoffman - Department of Radiology, University of Iowa, Iowa City, IA
Elsa Angelini - Department of Biomedical Engineering, Mailman School of Public Health, Columbia University, New York, NY
John H M Austin - Department of Radiology, College of Physicians and Surgeons, Columbia University, New York, NY
Mary Cushman - Department of Medicine, Larner College of Medicine at the University of Vermont, Colchester, VT; Department of Pathology, Larner College of Medicine at the University of Vermont, Colchester, VT
David R Jacobs Jr - Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
Joel D Kaufman - Department of Environmental Medicine and Occupational Health Sciences, University of Washington, Seattle, WA
Andrew Laine - Department of Biomedical Engineering, Mailman School of Public Health, Columbia University, New York, NY
Lewis J Smith - Department of Medicine, Northwestern University, Chicago, IL
Jie Yang - Department of Biomedical Engineering, Mailman School of Public Health, Columbia University, New York, NY
Karol E Watson - Department of Medicine, University of California, Los Angeles, CA
Russell P Tracy - Department of Pathology, Larner College of Medicine at the University of Vermont, Colchester, VT
R Graham Barr - Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
Resource Type: Journal article
Publication Details: Chest, Vol.154(1), pp.41-50
DOI: 10.1016/j.chest.2017.11.031
PMID: 29246770
PMCID: PMC6045779
NLM abbreviation: Chest
ISSN: 0012-3692
eISSN: 1931-3543
Publisher: United States
Grant note: P30 ES005605 / NIEHS NIH HHS N01HC95169 / NHLBI NIH HHS UL1 TR001422 / NCATS NIH HHS N01HC95161 / NHLBI NIH HHS R01 HL098077 / NHLBI NIH HHS R01 HL093081 / NHLBI NIH HHS N01HC95164 / NHLBI NIH HHS HHSN268201500003C / NHLBI NIH HHS N01HC95160 / NHLBI NIH HHS R01 HL121270 / NHLBI NIH HHS R01 HL112986 / NHLBI NIH HHS N01HC95167 / NHLBI NIH HHS RC1 HL100543 / NHLBI NIH HHS N01HC95159 / NHLBI NIH HHS N01HC95163 / NHLBI NIH HHS R01 HL077612 / NHLBI NIH HHS N01HC95166 / NHLBI NIH HHS UL1 TR000040 / NCATS NIH HHS N01HC95168 / NHLBI NIH HHS UL1 TR001079 / NCATS NIH HHS N01HC95165 / NHLBI NIH HHS P30 DK054759 / NIDDK NIH HHS N01HC95162 / NHLBI NIH HHS UL1 TR001420 / NCATS NIH HHS
Language: English
Date published: 07/2018
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051569502771

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