AUTHOR=Court Tatyana , Čapková Naděžda , Pająk Andrzej , Tamošiūnas Abdonas , Bobák Martin , Pikhart Hynek 

TITLE=Can spirometry improve the performance of cardiovascular risk model in high-risk Eastern European countries?

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1228807

DOI=10.3389/fcvm.2023.1228807

ISSN=2297-055X

ABSTRACT=Aims: Impaired lung function has been strongly associated with cardiovascular (CVD) events. We aimed to assess the additive prognostic value of spirometry indices to the risk estimation of CVD events in Eastern European populations.: We randomly selected 14061 individuals with a mean age of 59 ±7.3 years without previous history of cardiovascular and pulmonary diseases from population registers in the Czech Republic, Poland and Lithuania. Predictive values of standardised Z-scores of forced expiratory volume measured in one second (FEV1) and forced vital capacity (FVC) and FEV1 divided by height cubed (FEV1/ht 3 ) were tested. Cox proportional hazards models were used to estimate hazard ratios (HR) of CVD events of various spirometry indices over Framingham cardiovascular risk factors (FRS). The model performance was evaluated using Harrell's C-statistics, Likelihood Ratio tests (LR) and Bayesian Information Criterion (BIC).Results: All spirometry indices had a strong linear relation with the incidence of CVD events (HR ranged from 1.10 -1.12 between indices). The model stratified by FEV1/height 3 tertiles had a stronger link with CVD events than FEV1 and FVC. The risk of CVD event for the lowest vs. highest FEV1/height 3 tertile among people with low FRS was higher (HR: 2.35; 95% CI: 1.96-2.81) than among those with high FRS. Addition of spirometry indices showed a small but statistically significant improvement of the FRS model.particularly in the low-risk group. FEV1/ht 3 is a more sensitive predictor compared to other spirometry indices.