Abstract 15825: Pulmonary Disease Related Imaging Findings From Routine Chest CT Have Limited Added Value in Cardiovascular Disease Risk Prediction Beyond Cardiovascular Calcifications
Background: Certain pulmonary diseases are associated with cardiovascular disease (CVD). Whether pulmonary, mediastinal and pleural chest CT abnormalities reflecting these pulmonary diseases improve CVD risk estimation beyond what is possible with cardiovascular findings is unknown. To evaluate the incremental predictive value of pulmonary, mediastinal and pleural findings over cardiovascular imaging findings.
Methods: The cohort comprised 10 410 patients, who underwent diagnostic chest CT for non-cardiovascular indications. Using a case-cohort approach, CT scans from the cases and from a ≈10% random sample of the baseline cohort (n=1366) were visually graded for cardiovascular, pulmonary, mediastinal and pleural findings (Figure ). Using Cox proportional hazards analysis, two models were pre-specified: Model 1 comprising the cardiovascular imaging findings; Model 2 comprised the cardiovascular plus pulmonary, mediastinal and pleural imaging findings. We evaluated the incremental value of non-vascular findings in CVD event risk prediction by comparing discrimination and reclassification between the two models.
Results: During a mean follow-up of 3.7 years (max. 7.0 years), 1148 CVD events (cases) were identified. Addition of pulmonary, mediastinal and pleural findings 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 (NRI 6.5% (P<0.01)).
Conclusions: Pulmonary, mediastinal and pleural CT imaging findings do have limited additional predictive value in the identification of high CVD event risk subjects beyond cardiovascular CT imaging features.
- © 2013 by American Heart Association, Inc.