Short summary

PLUS:Hjerte builds on an existing screening program for heavy smokers (PLUS) and aims to investigate whether low-dose CT scans can be used to detect calcifications in the coronary arteries. Smoking increases the risk of lung cancer, but also of atherosclerosis. Approximately 600 patients from the Region of Southern Denmark will be included. If the project can demonstrate that calcifications can be detected through these scans, it may potentially be integrated into a final screening program.

Rationale

The background for PLUS:Hjerte originates from the ongoing lung cancer screening project (PLUS) in the Region of Southern Denmark, which is based on results from the NELSON study from 2020. This study showed that low-dose chest CT screening among heavy smokers significantly reduced lung cancer mortality. Based on these findings, the Danish Health Authority is considering implementing a similar screening program in Denmark. The PLUS project aims to clarify the organizational and resource-related aspects of such a program. Smoking not only increases the risk of lung cancer but also of atherosclerosis in the coronary arteries, which can lead to myocardial infarction. Despite this, calcifications in the heart are rarely reported on low-dose CT scans, as the scans are not ECG-gated, making it difficult to clearly visualize the calcifications. However, studies show that non-ECG gated low-dose CT scans mahy be used for this purpose. The goal of PLUS:Hjerte is to investigate whether the low-dose CT scans, already performed in the lung cancer screening program, can be used to detect calcifications in the heart. The project will compare calcium scores (CAC) from both low-dose CT scans and gold standard ECG-gated CT scans. If the results are comparable, it could lead to an integrated screening strategy that detects both lung cancer and cardiovascular disease, potentially improving prevention and treatment of both conditions.

Description of the cohort

Approximately 600 people participating in the PLUS project, who are scheduled for a CT scan at OUH, will be included.

Data and biological material

The following data are provided from the PLUS study: CPR number, name, digital post status, phone number, and the time and location of the scheduled PLUS scan. To ensure proper and appropriate execution, we also wish to collect the following project-relevant information from medical records/FMK: Previous cardiovascular disease ; Use of cardiovascular medication. A short medical history (chest pain and dyspnea) is obtained from the participants. The CAC scan is measured on the gold standard ECG-gated CT scan as well as the low-dose CT scans (the lung cancer screening scan). All data are stored in REDCap. The Data Protection Act and the General Data Protection Regulation (GDPR) will be complied with in this regard

Collaborating researchers and departments

Department of Cardiology, Odense University Hospital.

• Professor Axel Diederichsen
• Kristian A. Øvrehus
• Preman Kumarathurai

Department of Radiology

• Benjamin Schnack Rasmussen
• Marie Zöga Diederichsen

The Mærsk Mc-Kinney Møller Institute, SDU

• Victoria Blanes-Vidal