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Randomized Controlled Trial
. 2013 May 20;14(1):55.
doi: 10.1186/1465-9921-14-55.

Rate of progression of CT-quantified emphysema in male current and ex-smokers: a follow-up study

Firdaus A A Mohamed Hoesein  1 , Pieter Zanen, Pim A de Jong, Bram van Ginneken, H Marike Boezen, Harry J M Groen, Mathijs Oudkerk, Harry J de Koning, Dirkje S Postma, Jan-Willem J Lammers
Affiliations
Randomized Controlled Trial

Rate of progression of CT-quantified emphysema in male current and ex-smokers: a follow-up study

Firdaus A A Mohamed Hoesein et al. Respir Res. .

Abstract

Background: Little is known about the factors associated with CT-quantified emphysema progression in heavy smokers. The objective of this study was to investigate the effect of length of smoking cessation and clinical / demographical factors on the rate of emphysema progression and FEV1-decline in male heavy smokers.

Methods: 3,670 male smokers with mean (SD) 40.8 (17.9) packyears underwent chest CT scans and pulmonary function tests at baseline and after 1 and 3 years follow-up. Smoking status (quitted ≥5, ≥1-<5, <1 years or current smoker) was noted. Rate of progression of emphysema and FEV1-decline after follow-up were assessed by analysis of variance adjusting for age, height, baseline pulmonary function and emphysema severity, packyears, years in study and respiratory symptoms. The quitted ≥5 group was used as reference.

Results: Median (Q1-Q3) emphysema severity,<-950 HU, was 8.8 (5.1 - 14.1) and mean (SD) FEV1 was 3.4 (0.73) L or 98.5 (18.5) % of predicted. The group quitted '>5 years' showed significantly lower rates of progression of emphysema compared to current smokers, 1.07% and 1.12% per year, respectively (p<0.001). Current smokers had a yearly FEV1-decline of 69 ml, while subjects quit smoking >5 years had a yearly decline of 57.5 ml (p<0.001).

Conclusion: Quit smoking >5 years significantly slows the rate of emphysema progression and lung function decline.

Trial registration: Registered at http://www.trialregister.nl with trial number ISRCTN63545820.

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Figures

Figure 1
Figure 1
Flowchart of included subjects.
Figure 2
Figure 2
Graph showing the increase of emphysema (% lung volume below -950 HU) in two men, age 60 at the start of the observation (t=0) with 40 packyears smoked in GOLD stage 1 (height 175 cm). One is a current smoker, the other a >5 year quitter. For sake of clarity the other two smoking groups were omitted from this graph as their emphysema increase is within these extreme groups.
Figure 3
Figure 3
Graph showing the decrease of FEV1 in two men, age 60 at the start of the observation (t=0) with 40 packyears smoked in GOLD stage 1 (height 175 cm). One is a current smoker, the other a >5 year quitter. For sake of clarity the other two smoking groups were omitted from this graph as their FEV1 decrease.
See this image and copyright information in PMC

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