The purpose of this ancillary study proposal is to use computed tomographic imaging to identify which smokers with chronic obstructive pulmonary disease (COPD) are at greatest risk for the development of acute exacerbations of disease (AECOPD) and cardiovascular events. The investigators hypothesize that a subject's relative burden of emphysema, airway, and vascular disease (all indiscernible by standard lung function testing) all influence risk of adverse events and may respond differently to statin therapy. Finally, it is hypothesized that statin therapy will mitigate the disease related longitudinal progression of radiographic measures of disease. To perform this investigation, CT scans will be obtained on 400 subjects at their time of enrollment into the parent STATCOPE Investigation and at their study termination. With the assistance of the Data Coordinating Center (DCC) enrollment will include 200 subjects randomized to placebo and 200 subjects randomized to statin therapy. In this way the effect of statin therapy (and its interaction with CT measures of disease) on AECOPD, cardiovascular risk, and disease progression can be examined. Objective measures of emphysema and airway disease will be performed by Dr. Washko's lab (study PI). Additional objective measures of atherosclerotic vascular disease will be performed by Dr. Budoff's lab (study co- investigator).

Public Health Relevance

Computed tomographic measures of emphysema, airway, and vascular disease in a subset of smokers enrolled in the parent STATCOPE Investigation may allow the identification of which subjects with COPD are at greatest risk for the development of acute exacerbations of disease (AECOPD) as well as cardiovascular events. This may allow heightened awareness of which subjects are at greatest risk for adverse events and allow earlier, more aggressive preventive therapy.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL107246-03
Application #
8463236
Study Section
Special Emphasis Panel (ZHL1-CSR-G (O2))
Program Officer
Punturieri, Antonello
Project Start
2011-02-07
Project End
2015-01-31
Budget Start
2013-02-01
Budget End
2014-01-31
Support Year
3
Fiscal Year
2013
Total Cost
$413,585
Indirect Cost
$156,847
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Ash, Samuel Y; Harmouche, Rola; Ross, James C et al. (2018) Interstitial Features at Chest CT Enhance the Deleterious Effects of Emphysema in the COPDGene Cohort. Radiology 288:600-609
Diaz, Alejandro A; Strand, Matthew; Coxson, Harvey O et al. (2018) Disease Severity Dependence of the Longitudinal Association Between CT Lung Density and Lung Function in Smokers. Chest 153:638-645
Diaz, Alejandro A; Martinez, Carlos H; Harmouche, Rola et al. (2018) Pectoralis muscle area and mortality in smokers without airflow obstruction. Respir Res 19:62
Ash, Samuel Y; Harmouche, Rola; Putman, Rachel K et al. (2018) Association between acute respiratory disease events and the MUC5B promoter polymorphism in smokers. Thorax 73:1071-1074
Washko, George R; Kinney, Gregory L; Ross, James C et al. (2017) Lung Mass in Smokers. Acad Radiol 24:386-392
Gazourian, Lee; Ash, Samuel; Meserve, Emily E K et al. (2017) Quantitative computed tomography assessment of bronchiolitis obliterans syndrome after lung transplantation. Clin Transplant 31:
Ash, Samuel Y; Harmouche, Rola; Putman, Rachel K et al. (2017) Clinical and Genetic Associations of Objectively Identified Interstitial Changes in Smokers. Chest 152:780-791
Martinez, Carlos H; Diaz, Alejandro A; Meldrum, Catherine A et al. (2017) Handgrip Strength in Chronic Obstructive Pulmonary Disease. Associations with Acute Exacerbations and Body Composition. Ann Am Thorac Soc 14:1638-1645
Ash, Samuel Y; Harmouche, Rola; Ross, James C et al. (2017) The Objective Identification and Quantification of Interstitial Lung Abnormalities in Smokers. Acad Radiol 24:941-946
Diaz, Alejandro A; Young, Thomas P; Maselli, Diego J et al. (2017) Quantitative CT Measures of Bronchiectasis in Smokers. Chest 151:1255-1262

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