OBJECTIVE: The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events. METHODS: In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV1%predicted) and FEV1 divided by forced vital capacity (FVC; FEV1/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices. RESULTS:184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95% confidence interval (CI) 0.985-0.999) for FEV1%predicted, 1.000 (95%CI 0.986-1.015) for FEV1/FVC, 1.014 (95%CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95%CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (<0.015) and NRI (<2.8%) were minimal. Coronary artery calcium volume had a hazard ratio of 1.046 (95%CI 1.034-1.058) per 100 mm(3), an increase in C-index of 0.076 and an NRI of 16.9% (P < 0.0001). CONCLUSIONS:Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events. KEY POINTS: • Pulmonary CT biomarkers and spirometry are associated with cardiovascular events • These pulmonary measurements do not contain clinically relevant independent prognostic information • Only coronary calcium score improved cardiovascular risk prediction above age and smoking.
RCT Entities:
OBJECTIVE: The objective of this study was to investigate the association of spirometry and pulmonary CT biomarkers with cardiovascular events. METHODS: In this lung cancer screening trial 3,080 male participants without a prior cardiovascular event were analysed. Fatal and non-fatal cardiovascular events were included. Spirometry included forced expiratory volume measured in units of one-second percent predicted (FEV1%predicted) and FEV1 divided by forced vital capacity (FVC; FEV1/FVC). CT examinations were quantified for coronary artery calcium volume, pulmonary emphysema (perc15) and bronchial wall thickness (pi10). Data were analysed via a Cox proportional hazard analysis, net reclassification improvement (NRI) and C-indices. RESULTS: 184 participants experienced a cardiovascular event during a median follow-up of 2.9 years. Age, pack-years and smoking status adjusted hazard ratios were 0.992 (95% confidence interval (CI) 0.985-0.999) for FEV1%predicted, 1.000 (95%CI 0.986-1.015) for FEV1/FVC, 1.014 (95%CI 1.005-1.023) for perc15 per 10 HU, and 1.269 (95%CI 1.024-1.573) for pi10 per 1 mm. The incremental C-index (<0.015) and NRI (<2.8%) were minimal. Coronary artery calcium volume had a hazard ratio of 1.046 (95%CI 1.034-1.058) per 100 mm(3), an increase in C-index of 0.076 and an NRI of 16.9% (P < 0.0001). CONCLUSIONS: Pulmonary CT biomarkers and spirometry measurements were significantly associated with cardiovascular events, but did not contain clinically relevant independent prognostic information for cardiovascular events. KEY POINTS: • Pulmonary CT biomarkers and spirometry are associated with cardiovascular events • These pulmonary measurements do not contain clinically relevant independent prognostic information • Only coronary calcium score improved cardiovascular risk prediction above age and smoking.
Authors: Xueqian Xie; Yingru Zhao; Geertruida H de Bock; Pim A de Jong; Willem P Mali; Matthijs Oudkerk; Rozemarijn Vliegenthart Journal: Circ Cardiovasc Imaging Date: 2013-06-11 Impact factor: 7.792
Authors: Tamar S Polonsky; Robyn L McClelland; Neal W Jorgensen; Diane E Bild; Gregory L Burke; Alan D Guerci; Philip Greenland Journal: JAMA Date: 2010-04-28 Impact factor: 56.272
Authors: Firdaus A A Mohamed Hoesein; Bartjan de Hoop; Pieter Zanen; Hester Gietema; Cas L J J Kruitwagen; Bram van Ginneken; Ivana Isgum; Christian Mol; Rob J van Klaveren; Akkelies E Dijkstra; Harry J M Groen; H Marike Boezen; Dirkje S Postma; Mathias Prokop; Jan-Willem J Lammers Journal: Thorax Date: 2011-04-07 Impact factor: 9.139
Authors: Pim A de Jong; Martijn J A Gondrie; Constantinus F M Buckens; Peter C Jacobs; Willem P T h M Mali; Yolanda van der Graaf Journal: PLoS One Date: 2011-10-12 Impact factor: 3.240
Authors: K A M van den Bergh; M L Essink-Bot; G J J M Borsboom; E Th Scholten; M Prokop; H J de Koning; R J van Klaveren Journal: Br J Cancer Date: 2009-11-24 Impact factor: 7.640
Authors: Steve Halligan; Shedrack F Kenis; Oshaani Abeyakoon; Andrew A O Plumb; Susan Mallett Journal: Eur Radiol Date: 2020-02-21 Impact factor: 5.315