Journal article
Relationship between Emphysema Progression at CT and Mortality in Ever-Smokers: Results from the COPDGene and ECLIPSE Cohorts
Radiology, Vol.299(1), pp.222-231
04/2021
DOI: 10.1148/RADIOL.2021203531
PMCID: PMC7997617
PMID: 33591891
Abstract
Background The relationship between emphysema progression and long-term outcomes is unclear. Purpose To determine the relationship between emphysema progression at CT and mortality among participants with emphysema. Materials and Methods In a secondary analysis of two prospective observational studies, COPDGene (
, NCT00608764) and Evaluation of Chronic Obstructive Pulmonary Disease Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE;
, NCT00292552), emphysema was measured at CT at two points by using the volume-adjusted lung density at the 15th percentile of the lung density histogram (hereafter, lung density perc15) method. The association between emphysema progression rate and all-cause mortality was analyzed by using Cox regression adjusted for ethnicity, sex, baseline age, pack-years, and lung density, baseline and change in smoking status, forced expiratory volume in 1 second, and 6-minute walk distance. In COPDGene, respiratory mortality was analyzed by using the Fine and Gray method. Results A total of 5143 participants (2613 men [51%]; mean age, 60 years ± 9 [standard deviation]) in COPDGene and 1549 participants (973 men [63%]; mean age, 62 years ± 8) in ECLIPSE were evaluated, of which 2097 (40.8%) and 1179 (76.1%) had emphysema, respectively. Baseline imaging was performed between January 2008 and December 2010 for COPDGene and January 2006 and August 2007 for ECLIPSE. Follow-up imaging was performed after 5.5 years ± 0.6 in COPDGene and 3.0 years ± 0.2 in ECLIPSE, and mortality was assessed over the ensuing 5 years in both. For every 1 g/L per year faster rate of decline in lung density perc15, all-cause mortality increased by 8% in COPDGene (hazard ratio [HR], 1.08; 95% CI: 1.01, 1.16;
= .03) and 6% in ECLIPSE (HR, 1.06; 95% CI: 1.00, 1.13;
= .045). In COPDGene, respiratory mortality increased by 22% (HR, 1.22; 95% CI: 1.13, 1.31;
< .001) for the same increase in the rate of change in lung density perc15. Conclusion In ever-smokers with emphysema, emphysema progression at CT was associated with increased all-cause and respiratory mortality. © RSNA, 2021
See also the editorial by Lee and Park in this issue.
Details
- Title: Subtitle
- Relationship between Emphysema Progression at CT and Mortality in Ever-Smokers: Results from the COPDGene and ECLIPSE Cohorts
- Creators
- Samuel Y Ash - Brigham and Women's HospitalRaúl San José EstéparSean B Fain - COPD FoundationRuth Tal-Singer - University Hospitals Birmingham NHS Foundation TrustRobert A Stockley - AstraZenecaLars H Nordenmark - University of Nebraska Medical CenterStephen Rennard - University of Michigan–Ann ArborMeiLan K Han - National Jewish HealthDebora Merrill - University of PittsburghStephen M Humphries - University of DenverAlejandro A Diaz - Harvard UniversityStefanie E Mason - Harvard UniversityFarbod N Rahaghi - Harvard UniversityCarrie L Pistenmaa - Harvard UniversityFrank C Sciurba - University of PittsburghGonzalo Vegas-Sánchez-Ferrero - Harvard UniversityDavid A Lynch - University of DenverGeorge R Washko - Harvard UniversityCOPDGene InvestigatorsCOPD Biomarker Qualification Consortium
- Resource Type
- Journal article
- Publication Details
- Radiology, Vol.299(1), pp.222-231
- DOI
- 10.1148/RADIOL.2021203531
- PMID
- 33591891
- PMCID
- PMC7997617
- ISSN
- 0033-8419
- eISSN
- 1527-1315
- Grant note
- T32 HL007633 / NHLBI NIH HHS R01 HL116931 / NHLBI NIH HHS R01 HL107246 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS P01 HL114501 / NHLBI NIH HHS R01 HL149877 / NHLBI NIH HHS K23 HL141651 / NHLBI NIH HHS R01 HL122464 / NHLBI NIH HHS U01 HL089856 / NHLBI NIH HHS K23 HL136905 / NHLBI NIH HHS K08 HL145118 / NHLBI NIH HHS R21 HL140422 / NHLBI NIH HHS R01 HL089897 / NHLBI NIH HHS K24 HL138188 / NHLBI NIH HHS R01 HL116473 / NHLBI NIH HHS R01 HL150023 / NHLBI NIH HHS
- Language
- English
- Date published
- 04/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Electrical and Computer Engineering; Health and Human Physiology
- Record Identifier
- 9984274952802771
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