Lung cancer screening CT-based prediction of cardiovascular events
- PMID: 23769488
- DOI: 10.1016/j.jcmg.2013.02.008
Lung cancer screening CT-based prediction of cardiovascular events
Abstract
Objectives: The aim of this study was to derivate and validate a prediction model for cardiovascular events based on quantification of coronary and aortic calcium volume in lung cancer screening chest computed tomography (CT).
Background: CT-based lung cancer screening in heavy smokers is a very timely topic. Given that the heavily smoking screening population is also at risk for cardiovascular disease, CT-based screening may provide the opportunity to additionally identify participants at high cardiovascular risk.
Methods: Inspiratory screening CT of the chest was obtained in 3,648 screening participants. Next, smoking characteristics, patient demographics, and physician-diagnosed cardiovascular events were collected from 10 years before the screening CT (i.e., cardiovascular history) until 3 years after the screening CT (i.e., follow-up time). Cox proportional hazards analysis was used to derivate and validate a prediction model for cardiovascular risk. Age, smoking status, smoking history, and cardiovascular history, together with automatically quantified coronary and aortic calcium volume from the screening CT, were included as independent predictors. The primary outcome measure was the discriminatory value of the model.
Results: Incident cardiovascular events occurred in 145 of 1,834 males (derivation cohort) and 118 of 1,725 males and 2 of 89 females (validation cohort). The model showed good discrimination in the validation cohort with a C-statistic of 0.71 (95% confidence interval: 0.67 to 0.76). When high risk was defined as a 3-year risk of 6% and higher, 589 of 1,725 males were regarded as high risk and 72 of 118 of all events were correctly predicted by the model.
Conclusions: Quantification of coronary and aortic calcium volumes in lung cancer screening CT images-information that is readily available-can be used to predict cardiovascular risk. Such an approach might prove useful in the reduction of cardiovascular morbidity and mortality and may enhance the cost-effectiveness of CT-based screening in heavy smokers.
Keywords: CI; CT; cardiovascular disease; computed tomography; confidence interval; lung cancer screening; tobacco smoking; vascular calcification.
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Similar articles
-
Sex Differences in Coronary Artery and Thoracic Aorta Calcification and Their Association With Cardiovascular Mortality in Heavy Smokers.JACC Cardiovasc Imaging. 2019 Sep;12(9):1808-1817. doi: 10.1016/j.jcmg.2018.10.026. Epub 2019 Jan 16. JACC Cardiovasc Imaging. 2019. PMID: 30660540
-
Prognostic value of heart valve calcifications for cardiovascular events in a lung cancer screening population.Int J Cardiovasc Imaging. 2015 Aug;31(6):1243-9. doi: 10.1007/s10554-015-0664-4. Epub 2015 May 12. Int J Cardiovasc Imaging. 2015. PMID: 25962863 Free PMC article. Clinical Trial.
-
Extracoronary Thoracic and Coronary Artery Calcifications on Chest CT for Lung Cancer Screening: Association with Established Cardiovascular Risk Factors - The "CT-Risk" Trial.Acad Radiol. 2015 Jul;22(7):880-9. doi: 10.1016/j.acra.2015.03.005. Epub 2015 May 7. Acad Radiol. 2015. PMID: 25957500 Review.
-
Quantification of coronary artery calcium in nongated CT to predict cardiovascular events in male lung cancer screening participants: results of the NELSON study.J Cardiovasc Comput Tomogr. 2015 Jan-Feb;9(1):50-7. doi: 10.1016/j.jcct.2014.11.006. Epub 2014 Nov 20. J Cardiovasc Comput Tomogr. 2015. PMID: 25533223 Clinical Trial.
-
Validation and prognosis of coronary artery calcium scoring in nontriggered thoracic computed tomography: systematic review and meta-analysis.Circ Cardiovasc Imaging. 2013 Jul;6(4):514-21. doi: 10.1161/CIRCIMAGING.113.000092. Epub 2013 Jun 11. Circ Cardiovasc Imaging. 2013. PMID: 23756678 Review.
Cited by
-
Cardiovascular comorbidities and their prognostic value in small cell lung cancer patients with chemoradiotherapy.Clin Transl Oncol. 2024 Jun;26(6):1348-1356. doi: 10.1007/s12094-023-03359-3. Epub 2023 Dec 16. Clin Transl Oncol. 2024. PMID: 38103121
-
ERS/ESTS/ESTRO/ESR/ESTI/EFOMP statement on management of incidental findings from low dose CT screening for lung cancer.Eur J Cardiothorac Surg. 2023 Oct 4;64(4):ezad302. doi: 10.1093/ejcts/ezad302. Eur J Cardiothorac Surg. 2023. PMID: 37804174 Free PMC article. Review.
-
Association of Coronary Artery Calcium Detected by Routine Ungated CT Imaging With Cardiovascular Outcomes.J Am Coll Cardiol. 2023 Sep 19;82(12):1192-1202. doi: 10.1016/j.jacc.2023.06.040. J Am Coll Cardiol. 2023. PMID: 37704309
-
Opportunistic screening at chest computed tomography: literature review of cardiovascular significance of incidental findings.Cardiovasc Diagn Ther. 2023 Aug 31;13(4):743-761. doi: 10.21037/cdt-23-79. Epub 2023 Jul 21. Cardiovasc Diagn Ther. 2023. PMID: 37675086 Free PMC article. Review.
-
Feasibility of Simple Evaluation of Coronary Artery Calcium Using a Number of Chest Computed Tomography Slices: A Multicenter Study.Ann Vasc Dis. 2023 Mar 25;16(1):46-53. doi: 10.3400/avd.oa.22-00060. Ann Vasc Dis. 2023. PMID: 37006870 Free PMC article.
Publication types
MeSH terms
Associated data
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical