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European Radiology

, Volume 25, Issue 6, pp 1646–1654

First Online: 14 March 2015Received: 23 April 2014Revised: 16 September 2014Accepted: 10 November 2014

Abstract

ObjectiveCertain 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.

MethodsA 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.

ResultsDuring 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.

ConclusionPulmonary, 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

KeywordsChest CT imaging CVD risk prediction Pulmonary disease-related CT findings Cardiovascular imaging Cardiovascular disease Electronic supplementary materialThe online version of this article doi:10.1007-s00330-014-3495-0 contains supplementary material, which is available to authorized users.

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Autor: Pushpa M. Jairam - Pim A. de Jong - Willem P. Th. M. Mali - Ivana Isgum - Yolanda van der Graaf - on behalf of the PRO

Fuente: https://link.springer.com/







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