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01.01.2015 | Chest

Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

verfasst von: Richard A. P. Takx, Rozemarijn Vliegenthart, Firdaus A. A. Mohamed Hoesein, Ivana Išgum, Harry J. de Koning, Willem P. Th. M. Mali, Carlijn M. van der Aalst, Pieter Zanen, Jan-Willem J. Lammers, Harry J. M. Groen, Eva M. van Rikxoort, Michael Schmidt, Bram van Ginneken, Matthijs Oudkerk, Tim Leiner, Pim A. de Jong

Erschienen in: European Radiology | Ausgabe 1/2015

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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 mm³, 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

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Titel: Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study
verfasst von: Richard A. P. Takx
Rozemarijn Vliegenthart
Firdaus A. A. Mohamed Hoesein
Ivana Išgum
Harry J. de Koning
Willem P. Th. M. Mali
Carlijn M. van der Aalst
Pieter Zanen
Jan-Willem J. Lammers
Harry J. M. Groen
Eva M. van Rikxoort
Michael Schmidt
Bram van Ginneken
Matthijs Oudkerk
Tim Leiner
Pim A. de Jong
Publikationsdatum: 01.01.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 1/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3384-6

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Pulmonary function and CT biomarkers as risk factors for cardiovascular events in male lung cancer screening participants: the NELSON study

Abstract

Objective

Methods

Results

Conclusions

Key Points

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Abstract

Objective

Methods

Results

Conclusions

Key Points

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