Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?

Objective: Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings.Methods: A total of 10,410 patients underwent diagnostic chest CT for...

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Publicado en:European Radiology Vol. 25; no. 6; pp. 1646 - 1655
Autores principales: Jairam, Pushpa M, de Jong, Pim A, Mali, Willem P Th M, Isgum, Ivana, van der Graaf, Yolanda
Formato: research Journal Article
Publicado: Springer Nature Jun2015
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2015
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      pub: Springer Nature
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        atl: Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?
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          Jairam, Pushpa M
          de Jong, Pim A
          Mali, Willem P Th M
          Isgum, Ivana
          van der Graaf, Yolanda
      sug:
        subj:
          Tomography, X-Ray Computed Methods
          Cardiovascular Diseases
          Lung Diseases
          Lung Diseases Complications
          Cardiovascular Diseases Complications
          Diagnosis
          Female
          Aged
          Pleura
          Middle Age
          Male
          Mediastinum
          Predictive Value of Tests
          Cox Proportional Hazards Model
          Human
          Lung
          Prospective Studies
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Scales
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: Certain pulmonary diseases are associated with cardiovascular disease (CVD). Therefore we investigated the incremental predictive value of pulmonary, mediastinal and pleural features over cardiovascular imaging findings.Methods: A total of 10,410 patients underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, we visually graded CTs from the cases and from an approximately 10 % random sample of the baseline cohort (n = 1,203) for cardiovascular, pulmonary, mediastinal and pleural findings. The incremental value of pulmonary disease-related CT findings above cardiovascular imaging findings in cardiovascular event risk prediction was quantified by comparing discrimination and reclassification.Results: During a mean follow-up of 3.7 years (max. 7.0 years), 1,148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural features to a cardiovascular imaging findings-based prediction model led to marginal improvement of discrimination (increase in c-index from 0.72 (95 % CI 0.71-0.74) to 0.74 (95 % CI 0.72-0.75)) and reclassification measures (net reclassification index 6.5 % (p < 0.01)).Conclusion: Pulmonary, mediastinal and pleural features have limited predictive value in the identification of subjects at high risk of CVD events beyond cardiovascular findings on diagnostic chest CT scans.Key Points: • Incidental cardiovascular findings on routine chest CT can predict cardiovascular disease • Non-cardiovascular chest CT abnormalities are associated with cardiovascular disease • Non-cardiovascular chest CT features have limited predictive value beyond cardiovascular features.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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