FEV₁ is a stronger mortality predictor than FVC in patients with moderate COPD and with an increased risk for cardiovascular disease

Figures & data

Table 1 Association Between Lung Function Indices and Time to Mortality, Cardiovascular Events, Moderate and Severe Exacerbations, and Severe Exacerbations

		Time to Death Risk Reduction vs. Q1	Time to First Major Cardiovascular Event  Risk Reduction vs. Q1	Time to First Moderate/Severe Exacerbation Risk Reduction vs. Q1	Time to First Severe Exacerbation Risk Reduction vs. Q1
FEV1% Predicted	Q1 <53.5%
	Q2 53.5 to 57.5%	20% (4 to 34%)	5% (−20 to 25%)	11% (3 to 19%)	10% (−5 to 23%)
	Q3 57.5 to 61.6%	28% (13 to 40%)	15% (−8 to 33%)	15% (7 to 22%)	25% (12 to 37%)
	Q4 61.6 to 65.8	23% (7 to 36%)	9% (−15 to 28%)	23% (16 to 30%)	37% (25 to 47%)
	Q5 ≥65.8%	30% (15 to 42%)	7% (−18 to 26%)	27% (20 to 33%)	40% (28 to 49%)
FVC % Predicted	Q1 <67.4%
	Q2 67.4 to 73.6%	14% (−4 to 29%)	16% (−7 to 34%)	2% (−8 to 10%)	4% (−15 to 20%)
	Q3 73.6 to 79.5%	11% (−8 to 27%)	−4% (−30 to 17%)	−4% (−14 to 5%)	0% (−20 to 17%)
	Q4 79.5 to 87.6%	14% (−4 to 29%)	11% (−13 to 29%)	−6% (−17 to 3%)	−13% (−34 to 6%)
	Q5 ≥87.6%	21% (4 to 35%)	21% (−1 to 38%)	−22% (−34 to −11%)	−28% (−52 to −8%)
FEV1/FVC	Q1 <0.51
	Q2 0.51 to 0.57	0% (−21 to 16%)	−7% (−36 to 16%)	18% (11 to 25%)	22% (9 to 33%)
	Q3 0.57 to 0.62	7% (−12 to 24%)	−8% (−38 to 15%)	28% (22 to 35%)	39% (28 to 49%)
	Q4 0.62 to 0.66	10% (−10 to 26%)	−12% (−43 to 12%)	29% (22 to 35%)	41% (29 to 50%)
	Q5 ≥0.66	−5% (−28 to 14%)	−18% (−50 to 8%)	36% (30 to 42%)	48% (37 to 57%)

Notes: Results are from Cox Proportional Hazard models and are presented as risk reduction compared with Q1 quintile groups (with 95% confidence intervals). These are calculated as (1–hazard ratio) × 100. Negative % reductions indicate increase in risk, i.e., hazard ratio >1. Nominally significant differences are presented in bold (p<0.05, no adjustment for multiplicity).

Abbreviations: FEV₁, forced expiratory volume in one second; FVC, forced vital capacity.

Table 2 Distribution of Participants in Lung Function Quintiles at Screening and Baseline

	FEV1	Screening
		Q1: <53.5% (N=3296)	Q2: ≥53.5 to <57.5% (N=3297)	Q3: ≥57.5 to <61.6% (N=3297)	Q4: ≥61.6 to <65.6% (N=3297)	Q5: ≥65.6% (N=3296)
BASELINE	Q1: <52.3% (N=3296)	1844	858	350	178	65
	Q2: ≥52.3 to <56.7% (N=3297)	941	1167	741	311	137
	Q3: ≥56.7 to <61.1% (N=3297)	319	808	1109	732	329
	Q4: ≥61.1 to <66.0% (N=3297)	119	308	743	1235	892
	Q5: ≥66.0% (N=3297)	73	156	354	841	1873
	FVC	Q1: <67.4% (N=3296)	Q2: ≥67.4 to <73.6% (N=3297)	Q3: ≥73.6 to <79.5% (N=3297)	Q4: ≥79.5 to <87.6% (N=3297)	Q5: ≥87.6% (N=3297)
	Q1: <52.3% (N=3296)	2173	702	264	113	44
	Q2: ≥65.9 to <72.6% (N=3297)	798	1412	739	266	82
	Q3: ≥72.6 to <78.8% (N=3297)	224	856	1357	690	170
	Q4: ≥78.8 to <87.2% (N=3297)	68	272	773	1548	635
	Q5: ≥87.2% (N=3297)	33	55	164	680	2365
	FEV1/FVC	Q1: <0.51 (N=3296)	Q2: ≥0.51 to <0.57 (N=3297)	Q3: ≥0.57 to <0.62 (N=3297)	Q4: ≥0.62 to <0.66 (N=3296)	Q5: ≥0.66 (N=3297)
	Q1: <0.51 (N=3296)	2480	610	122	37	33
	Q2: ≥0.51 to <0.57 (N=3297)	609	1668	720	196	90
	Q3: ≥0.57 to <0.62 (N=3297)	112	718	1428	757	269
	Q4: ≥0.62 to <0.66 (N=3296)	52	181	716	1407	955
	Q5: ≥0.66 (N=3297)	33	103	296	888	1935

Abbreviations: FEV₁, forced expiratory volume in one second; FVC, forced vital capacity.

Figure 1 Kaplan–Meier plot showing unadjusted relationship between FEV₁% predicted at screening and all-cause mortality.

Abbreviations: FEV₁, forced expiratory volume in one second; N, number of patients.