title: The value of computed tomography scanning for the detection of coronary artery disease in patients with idiopathic pulmonary fibrosis.
abstract: OBJECTIVE
  Patients with idiopathic pulmonary fibrosis (IPF) have a higher prevalence of coronary artery disease and this could have an impact on their outcomes. We investigated the predictive ability of coronary artery calcification, assessed by routine CT, which may predict the presence of coronary artery disease.
  
  
  METHODS
  The study cohort consisted of patients with IPF and with left heart catheterization data plus CT scans from July 2003 to July 2008. Grades of coronary calcification on CT were compared with left heart catheterization determination of coronary artery disease.
  
  
  RESULTS
  There were 57 patients in whom left heart catheterization review demonstrated significant coronary artery disease in 28.1% (16/57), mild disease in 40.3% (23/57) and none in 31.6% (18/57). The median time interval between the catheterization and the reviewed CT scan was 39 days. The sensitivity of moderate to severe calcification for significant coronary artery disease was 81%, while the specificity was 85%, with an associated odds ratio of 25.2 (4.64-166, P < 0.005). There was excellent agreement among three radiologists in the grading of coronary calcification.
  
  
  CONCLUSIONS
  Coronary calcification, as assessed by routine CT of the chest, has very good performance characteristics in predicting underlying significant coronary artery disease in patients with IPF. The routine availability of this study enables the ready screening for coronary artery disease in IPF patients.
authors.affiliation: Inova Transplant Center, Inova Fairfax Hospital, Falls Church, Virginia 22042, USA. steven.nathan@inova.org
authors.forename: Steven D
authors.initials: SD
authors.lastname: Nathan
authors.forename: Nargues
authors.initials: N
authors.lastname: Weir
authors.forename: Oksana A
authors.initials: OA
authors.lastname: Shlobin
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Urban
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Curry
authors.forename: Ashwin
authors.initials: A
authors.lastname: Basavaraj
authors.forename: Shahzad
authors.initials: S
authors.lastname: Ahmad
authors.forename: Joseph
authors.initials: J
authors.lastname: Kiernan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sheridan
authors.forename: James P
authors.initials: JP
authors.lastname: Earls
mesh_terms: D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006328:Cardiac Catheterization; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed