Chest最新文献

{"title":"A Prospective, Multicenter Evaluation of Safety and Diagnostic Outcomes with Robotic-Assisted Bronchoscopy: Results of the Transbronchial Biopsy Assisted by Robot Guidance in the Evaluation of Tumors of the Lung (TARGET) Trial.","authors":"Septimiu Murgu,Alexander C Chen,Christopher R Gilbert,Daniel H Sterman,Damaris Pederson,Samaan Rafeq,Balaji Laxmanan,Michael L Schwiers,Jaime Connelly,Heather L Benz,Kazuhiro Yasufuku,Gerard A Silvestri,","doi":"10.1016/j.chest.2025.04.022","DOIUrl":"https://doi.org/10.1016/j.chest.2025.04.022","url":null,"abstract":"BACKGROUNDIt remains challenging to safely and reliably biopsy peripheral pulmonary lesions (PPLs). Robotic-assisted bronchoscopy (RAB) is gaining adoption for navigation to PPLs. However, evidence from large studies remains limited.RESEARCH QUESTIONWhat is the clinical safety, navigational success, and diagnostic yield of RAB for biopsy of PPLs in a broad range of patients in a real-world setting?STUDY DESIGN AND METHODSThis multicenter, prospective, single-arm study enrolled patients >21 years old with 8-50 mm lung lesions requiring bronchoscopic diagnosis. The primary endpoint was the incidence of the following device- or procedure-related events: (1) pneumothorax requiring intervention; (2) bleeding requiring intervention; or (3) respiratory failure. Secondary endpoints included individual components of the primary endpoint, procedure time, pneumothoraces, radial probe endobronchial ultrasound (R-EBUS) confirmation, conversion to an alternative biopsy procedure, complications, and diagnostic yield (DY).RESULTSAmong 715 patients at 21 sites, 679 met study criteria and underwent RAB (mean age 68.7, 55.4% female, 86.5% White, 77.5% current/past tobacco users). Mean (range) lesion size was 20.9 (7.0-63.0) mm; median (IQR) distance from pleural surface was 5 (0-16) mm. Most lesions were solid (n=587; 86.6%) and within the outer two-thirds of the lung (n=593; 87.5%). The primary endpoint was observed in 26 (3.8%) patients (19 pneumothorax, 7 bleeding, 0 respiratory failure). Users reported that RAB reached the lesion in 670/679 (98.7%) cases, and lesion location was confirmed with R-EBUS in 607/662 (91.7%) cases; sampling through the bronchoscope was performed in 675/679 (99.4%) cases. Prevalence of malignancy was 64.1% through 12 months. Adjudicated DY was 61.6% when calculated with the American Thoracic Society (ATS)/American College of Chest Physicians (ACCP) definition for strict reporting criteria. Sensitivity for malignancy was 78.8%.INTERPRETATIONThis largest multicenter prospective study of RAB to date demonstrated that RAB-guided sampling of PPLs is safe and compares favorably to results from sizable non-robotic bronchoscopy studies.CLINICAL TRIAL REGISTRATION NUMBERNCT04182815.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"91 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung Quantitative Computed Tomography Textures are Associated with Systemic Inflammation and Mortality in COPD.","authors":"Hira A Awan,Muhammad F A Chaudhary,Anthony D El-Sokkary,Eric A Hoffman,Alejandro P Comellas,Junfeng Guo,Igor Z Barjaktarevic,R Graham Barr,Surya P Bhatt,Sandeep Bodduluri,Russell P Bowler,Luis G Vargas Buonfiglio,Christopher B Cooper,Ashraf Fawzy,Annette T Hastie,Wassim W Labaki,Fernando J Martinez,Martha G Menchaca,Wanda O'Neal,Robert Paine,Joyce D Schroeder,Prescott G Woodruff,Jeffrey L Curtis,Joseph M Reinhardt","doi":"10.1016/j.chest.2025.04.017","DOIUrl":"https://doi.org/10.1016/j.chest.2025.04.017","url":null,"abstract":"BACKGROUNDChronic obstructive pulmonary disease (COPD) is characterized by persistent inflammation that is responsible for remodeling the bronchovascular bundles, which may lead to poor quality of life. Quantitative computed tomography (QCT) textures of the lung can capture local disease patterns of inflammation and related respiratory morbidity.RESEARCH QUESTIONAre bronchovascular bundle textures, obtained from the adaptive multiple feature method (AMFM), associated with systemic inflammation, morbidity, and mortality in COPD?STUDY DESIGN AND METHODSWe analyzed data from the SPIROMICS (n = 2,981) and COPDGene (n = 10,305) studies. The predictors included two QCT biomarkers, the bronchovascular bundles (BVB) and CT density gradient (CTDG) textures, age, sex, BMI, race, smoking status, smoking pack-years, CT emphysema, and Pi10 (airway wall thickness). Outcomes included plasma biomarker concentrations from Meso Scale Discovery proteomics assays and complete blood counts, both as markers of inflammation, along with FEV1, FEV1/FVC ratio, SGRQ, 6MWD, and mMRC dyspnea scale. Associations of these QCT textures with FEV1 decline and all-cause mortality were also investigated.RESULTSIncreased BVB texture was significantly associated with elevated neutrophil and monocyte counts, and the neutrophil-to-lymphocyte ratio (NLR), independent of clinical covariates, CT emphysema, and Pi10. Elevated CTDG was associated with increased neutrophil count, NLR, and tumor necrosis factor (TNF)-α. Increased CTDG and BVB textures were also associated with a lower FEV1 and six-minute walk distance. CTDG at baseline was also associated with decline in FEV1 at five-year follow-up in COPDGene. We observed a significant association of both BVB (HRSPIROMICS=1.084, 95% CI: 1.035, 1.135, P<0.001; HRCOPDGene=1.106, 95% CI: 1.080, 1.131, P<0.001) and CTDG (HRSPIROMICS=1.033, 95% CI: 1.003, 1.064, P=0.03; HRCOPDGene=1.079, 95% CI: 1.061, 1.096, P<0.001) textures with all-cause mortality independent of CT emphysema and Pi10.INTERPRETATIONQCT textures may provide imaging evidence of the spatial heterogeneity of lung inflammation and overall disease burden in COPD.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"53 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Operative Lung Transplant Considerations in the Older Recipient.","authors":"Sandrine Hanna,Kristi Beermann,Deborah J Levine,Gabriel Loor,Jonathan P Singer,Patrick J Smith,Hakim Azfar Ali","doi":"10.1016/j.chest.2024.10.060","DOIUrl":"https://doi.org/10.1016/j.chest.2024.10.060","url":null,"abstract":"TOPIC IMPORTANCELung transplantation (LTx) remains the ultimate treatment for many patients with advanced lung disease. While the age cutoffs for LTx have been debated due to variable outcomes, the number of LTx procedures performed on patients aged 65 and older has significantly increased in recent decades, reflecting the realities of an aging demographic. This trend underscores the unique management challenges faced by this cohort and highlights the importance of addressing evidence gaps in their perioperative and postoperative care.REVIEW FINDINGSOur literature review highlights that, despite the challenges, recent data indicate favorable outcomes for patients aged 65 and older undergoing LTx. Although the primary focus of this article is on post-operative care, it also addresses some peri-operative considerations including the use of extra-corporeal life support, as well as the choice of the procedure type and donor considerations. This review incorporates current knowledge about early and late postoperative complications, including neurological, cardiovascular, renal, among others, along with their management strategies and current practice patterns. .SUMMARYIn conclusion, this review emphasizes the need to optimize care for older LTx recipients. The evidence regarding ideal management practices for this population is limited. We highlight the necessity for comprehensive postoperative management guidelines and identify key areas for further research to establish evidence-based protocols for this growing demographic.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"3 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on Pulmonary Critical Care Fellows In-Training Exam Performance: A National Study.","authors":"Mahmoud Alwakeel,Paru Patrawalla,Brian Carlin,Doreen Adrizzo-Harris,John Mastronarde,Joyce Reitzner,Hiram L Rivas Perez,XiaoFeng Wang,Neal Chaisson","doi":"10.1016/j.chest.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.chest.2025.04.015","url":null,"abstract":"BACKGROUNDBetween 2020 and 2022, the COVID-19 pandemic disrupted health and education. Many training institutions modified trainees' rotations, decreasing outpatient clinics while increasing inpatient and ICU time. Understanding pandemic's impact on medical trainees' cognitive performance is essential for informing strategies and supporting trainee well-being during crises.RESEARCH QUESTIONWhat was the impact of the COVID-19 pandemic on the performance of Pulmonary and Critical Care Medicine (PCCM) fellows on the in-training examination (ITE)?STUDY DESIGN AND METHODSRetrospective study included all PCCM fellows in US who completed the PCCM-ITE between April 2015 and July 2022. Participants were divided into three cohorts. Pre-pandemic (PP) (ITE before March 1, 2020), a 1st COVID wave (CW1) (March 1, 2020 - June 30, 2021), and 2nd CW cohorts (CW2) (on or after July 1, 2021). We used a linear mixed effect model to explore the relationship between the pandemic and ITE scores.RESULTSA total of 12,774 PCCM-ITE exam scores were evaluated for 8391 individuals. During CW1, LS mean total scores for FY0 and FY1 were similar to those in the PP. However, FY2 and FY3 demonstrated higher LS mean total scores, with differences of 2.0% (95% CI 0.4%-3.5%, p=0.02) and 2.9% (95% CI 1.3%-4.6%, p=0.001), respectively, compared to the PP. LS mean pulmonary subsection scores were 5.3% (95% CI 1.5%-9.1%, p=0.01) higher for FY3 trainees during CW1 while no significant differences were observed for other trainee levels during CW1 or CW2. Critical care subsection scores were similar for FY1, FY2, and FY3 trainees across all time periods. FY0 trainees had lower critical care scores during CW1 (-2.2%, 95% CI -4.3%--0.1%, p=0.04) and CW2 (-2.9%, 95% CI -4.9%--0.8%, p=0.007), compared to PP.INTERPRETATIONIn conclusion, pandemic impacts on cognitive performance were minimal, possibly buffered by enhanced self-study opportunities among trainees during CW1.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"53 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise hemodynamics and the evolving definition of precapillary pulmonary hypertension.","authors":"Louisa A Mounsey,Ceanna J Kalaria,Alyssa Kowal,Casey Hoenstine,Shaina McGinnis,Isabela Landsteiner,Rajeev Malhotra,Greg D Lewis,Alexandra K Wong,Alison S Witkin,Josanna Rodriguez-Lopez,C Corey Hardin","doi":"10.1016/j.chest.2025.03.035","DOIUrl":"https://doi.org/10.1016/j.chest.2025.03.035","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"35 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"XALOC-1: Clinical remission over 2-years with benralizumab in severe eosinophilic asthma.","authors":"Girolamo Pelaia,David J Jackson,Parameswaran Nair,Benjamin Emmanuel,Trung N Tran,Andrew Menzies-Gow,Michael Watt,Sheena Kayaniyil,Silvia Boarino,Javier Nuevo,Marisa Pardal,Anat Shavit,Vivian H Shih,David Cohen,Claudia Loureiro,Alicia Padilla-Galo","doi":"10.1016/j.chest.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.chest.2025.04.011","url":null,"abstract":"BACKGROUNDLong-term real-world data on clinical remission in patients with severe eosinophilic asthma (SEA) receiving biologics are lacking. We describe clinical remission over 2 years in patients with SEA receiving benralizumab.RESEARCH QUESTIONIs long-term clinical remission a viable goal for patients with SEA receiving benralizumab?STUDY DESIGN AND METHODSXALOC-1 is a multinational, retrospective, real-world program in adults with SEA who received benralizumab for ≤96 weeks. Percentages of patients meeting the components and composite of clinical remission (no exacerbations, no maintenance oral corticosteroid [mOCS] use, and well-controlled asthma [Asthma Control Test score ≥20 or 6-item Asthma Control Questionnaire score ≤0.75 ]) were assessed at Weeks 0, 48, and 96. The association between key baseline demographics, clinical characteristics, and clinical remission status was assessed at Weeks 48 and 96 using multivariable logistic regression analysis.RESULTSOf 1070 patients, 0.4%, 39%, and 31% met the 3-component clinical remission criteria at Weeks 0, 48, and 96, respectively. In biologic-naïve and biologic-experienced patients, remission occurred in 43% and 32% (Week 48), and 36% and 23% (Week 96) of patients, respectively. Lower mOCS dose (odds ratio [95% confidence interval] 0.51 [0.34, 0.76]), lower body mass index (0.56 [0.36, 0.86]), and higher peak eosinophil count (1.68 [1.05, 2.69]) at baseline were positively associated with meeting criteria for clinical remission at Week 96.INTERPRETATIONClinical remission is a realistic goal, sustainable up to 2 years in around one-third of patients with SEA receiving benralizumab. Remission was more likely in patients with lower baseline disease burden, suggesting that further research is warranted regarding whether earlier initiation of a biologic may be beneficial.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"17 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of physical frailty with incidence and life expectancy of chronic obstructive pulmonary disease: a population-based cohort study.","authors":"Chao Liu,Hui Xiong,Xia Han,Yanling Lv,Decai Wang,Jiannan Hu,Ziling Li,Xinyue Ma,Yunfei Zhu,Shuyun Xu,Liangkai Chen","doi":"10.1016/j.chest.2025.03.032","DOIUrl":"https://doi.org/10.1016/j.chest.2025.03.032","url":null,"abstract":"BACKGROUNDThe bidirectional relationship between frailty and chronic obstructive pulmonary disease (COPD) is documented. However, longitudinal studies examining the combined effects of genetic predisposition and preserved ratio impaired spirometry (PRISm) on frailty in COPD development are lacking.RESEARCH QUESTIONWhat is the association between physical frailty and the incidence and mortality of COPD, and how do genetic predisposition and PRISm modify this association?STUDY DESIGN AND METHODSWe included 412,351 adults without COPD (mean age 56.1±8.1 years, 44.3% male) and 60,584 COPD patients (mean age 59.2±7.4 years, 55.1% male) at baseline in the UK Biobank cohort. Frailty phenotypes were assessed using five components, including weight loss, exhaustion, low physical activity, slow gait speed, and low grip strength. Cox proportional hazards regression models were employed to evaluate the association of genetic predisposition, PRISm, and frailty with COPD development. Life expectancy reductions due to frailty were estimated using life table methods in COPD patients.RESULTSDuring a median follow-up of 13.5 years, 10,695 incident COPD cases were recorded. In the multivariable-adjusted model, frailty and prefrailty were significantly associated with an increased risk of COPD (HR 2.21, 95% CI: 2.06-2.37 for frailty; HR 1.45, 95% CI: 1.39-1.51 for prefrailty). Significant interactions were observed between genetic predisposition and frailty (Pinteraction=0.0252), as well as between PRISm and frailty (Pinteraction=0.0027), in the development of COPD. Among patients with COPD at age 45, frailty was associated with a reduction in life expectancy of 8.49 years for males and 7.67 years for females, while prefrailty was associated with reductions of 3.27 and 2.78 years, respectively, compared to their non-frail counterparts.INTERPRETATIONFrailty and prefrailty increase COPD risk and are linked to reduced life expectancy in patients with COPD, highlighting the need for early detection and management of frailty in COPD prevention and treatment strategies.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"6 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of tirzepatide on patients with obstructive sleep apnea and obesity.","authors":"Jheng-Yan Wu,Chia-Chen Chen,Wan-Ling Tu,Wan-Hsuan Hsu,Ting-Hui Liu,Ya-Wen Tsai,Po-Yu Huang,Min-Hsiang Chuang,Kuo-Chuan Hung,Tsung Yu,Chih-Cheng Lai","doi":"10.1016/j.chest.2025.03.030","DOIUrl":"https://doi.org/10.1016/j.chest.2025.03.030","url":null,"abstract":"BACKGROUNDObstructive sleep apnea (OSA) is a prevalent chronic condition linked to obesity and associated with increased risks of cardiovascular and kidney disease. While weight loss can improve OSA outcomes, additional effective therapeutic options are needed. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has shown promise in promoting significant weight loss and reducing OSA severity.RESEARCH QUESTIONDoes tirzepatide affect clinical outcomes in individuals with OSA and obesity?STUDY DESIGN AND METHODSThis study was conducted using the TriNetX Global Collaborative Network and included adults with OSA and obesity between January 1, 2022, and November 30, 2024. Patients were divided into two groups: those prescribed tirzepatide (study group) and those receiving lifestyle interventions (control group). Propensity score matching (PSM) was applied to balance covariates. The primary outcome was all-cause mortality, with secondary outcomes including major adverse cardiovascular events (MACE) and major adverse kidney events (MAKE).RESULTSAfter PSM, the study included 42,300 patients (21,150 in each group). The tirzepatide group was associated with a lower risk of all-cause mortality (HR, 0.443; 95% CI, 0.336-0.583). Tirzepatide use was also associated with reduced risks of MACE (HR, 0.731; 95% CI, 0.622-0.859) and MAKE (HR, 0.427; 95% CI, 0.343-0.530). Except for the 18-39 age group, these associations remained consistent across all other subgroups when stratified by age, sex, body mass index, and continuous positive airway pressure use. Sensitivity analyses supported the robustness of these findings.INTERPRETATIONTirzepatide could be associated with reduced mortality, cardiovascular events, and kidney-related complications in patients with OSA and obesity. These findings suggest that tirzepatide may be a potential therapeutic option for improving clinical outcomes in this population.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"66 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local anaesthetic use in pleural procedures: time to re-consider the guidelines?","authors":"Craig Mounsey,Imogen R Mechie,Dinesh N Addala,Rhea Suribhatla,Zara O Small,Ella M Smith,Robyn Ae Gould,Grace A Annetts,Daniela Krouzkova,Nikolaos I Kanellakis,Najib M Rahman","doi":"10.1016/j.chest.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.chest.2025.04.010","url":null,"abstract":"","PeriodicalId":9782,"journal":{"name":"Chest","volume":"41 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Calcification Identified on Lung Cancer Screening CT Scans: A Scoping Review.","authors":"Nada Al-Antary,Kelly A Hirko,Andrea E Cassidy-Bushrow,Katie R Zarins,Mike J Simoff,Thomas Song,Avi Cohen,Christine Neslund-Dudas","doi":"10.1016/j.chest.2025.03.031","DOIUrl":"https://doi.org/10.1016/j.chest.2025.03.031","url":null,"abstract":"TOPIC IMPORTANCECoronary artery calcification (CAC) can be a significant incidental finding on low-dose computed tomography (CT) scans performed for lung cancer screening (LCS). CAC presence and grade hold important diagnostic, and preventive value, particularly in patients without previously recognized coronary artery disease. This scoping review describes the prevalence of CAC as an incidental finding on LCS CT scans across prior studies and identifies directions for future research.REVIEW FINDINGSThe initial search resulted in 256 abstracts screened for eligibility, resulting in 32 articles included in the final review. CAC presence across included studies varied from 14.8% to 98%. CAC was most commonly reported as mild in grade, among 46.9% of studies. The majority of studies were conducted among predominantly White male participants. Finally, only 6 articles provided information on down-stream interventions for patients with newly detected CAC.SUMMARYCAC, a predictive risk factor for cardiovascular events and mortality, is a frequently detected incidental finding on LCS CT scans, with substantial variation in presence across studies. Identification of CAC on LCS CT could inform clinical decisions to reduce patients' overall cardiovascular risk. These findings underscore the significance of standardizing the documentation and management of CAC in LCS. Finally, future studies should include greater race diversity.","PeriodicalId":9782,"journal":{"name":"Chest","volume":"18 1","pages":""},"PeriodicalIF":9.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}