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

Richard A. P. Takx*, Rozemarijn Vliegenthart, Firdaus A. A. Mohamed Hoesein, Ivana Isgum, 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

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

9 Citaten (Scopus)


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 (

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.

Originele taal-2English
Pagina's (van-tot)65-71
Aantal pagina's7
TijdschriftEuropean Radiology
Nummer van het tijdschrift1
StatusPublished - jan.-2015

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