Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study.
Eur Radiol
; 25(1): 65-71, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25182625
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
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Tomografia Computadorizada por Raios X
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Programas de Rastreamento
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Detecção Precoce de Câncer
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Neoplasias Pulmonares
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Etiology_studies
/
Incidence_studies
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Prognostic_studies
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Risk_factors_studies
/
Screening_studies
Limite:
Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur Radiol
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article