TY - JOUR
T1 - Cardiovascular disease prediction: do pulmonary disease-related chest CT features have added value?
AU - Jairam, Pushpa M.
AU - de Jong, Pim A.
AU - Mali, Willem P. Th. M.
AU - Isgum, Ivana
AU - van der Graaf, Yolanda
PY - 2015
Y1 - 2015
N2 - 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
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
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84939963818&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/25773934
U2 - https://doi.org/10.1007/s00330-014-3495-0
DO - https://doi.org/10.1007/s00330-014-3495-0
M3 - Article
C2 - 25773934
SN - 0938-7994
VL - 25
SP - 1646
EP - 1654
JO - European Radiology
JF - European Radiology
IS - 6
ER -