title: FEV1 is a better predictor of mortality than FVC: the PLATINO cohort study.
abstract: OBJECTIVE
  To determine whether the presence of chronic obstructive lung disease (COPD) and reduction of lung function parameters were predictors of mortality in a cohort.
  
  
  METHODS
  Population based cohorts were followed in Montevideo, Santiago and Sao Paulo during 5, 6 and 9 years, respectively. Outcomes included all-cause, cardiovascular, respiratory and cancer mortality; exposures were COPD, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Cox regression was used for analyses. Sensitivity, specificity, positive and negative predictive values, receiver operator characteristics curves and Youden's index were calculated.
  
  
  RESULTS
  Main causes of death were cardiovascular, respiratory and cancer. Baseline COPD was associated with overall mortality (HR = 1.43 for FEV1/FVC<LLN; 2.01 for GOLD 2-4; 1.46 for GOLD 1-4; 1.50 for FEV1/FEV6 <LLN). For cardiovascular mortality, significant associations were found with GOLD 2-4 (HR = 2.68) and with GOLD 1-4 (HR = 1.78) for both genders together (not among women). Low FEV1 was risk for overall and respiratory mortality (both genders combined). FVC was not associated with overall mortality. For most COPD criteria sensitivity was low and specificity high. The area under the curve for FEV1 was greater than for FVC for overall and cardiovascular mortality.
  COPD and low FEV1 are important predictors for overall and cardiovascular mortality in Latin America.
authors.affiliation: Federal University of Pelotas, Post-graduate Program in Epidemiology, Pelotas, Brazil.
authors.forename: Ana Maria B
authors.initials: AM
authors.lastname: Menezes
authors.affiliation: National Institute of Respiratory Diseases, Sleep Clinic and Pulmonary Physiology, Mexico City, Mexico.
authors.forename: Rogelio
authors.initials: R
authors.lastname: Pérez-Padilla
authors.affiliation: Federal University of Pelotas, Post-graduate Program in Epidemiology, Pelotas, Brazil.
authors.forename: Fernando César
authors.initials: FC
authors.lastname: Wehrmeister
authors.affiliation: Universidad de la Republica, Facultad de Medicina, Montevideo, Uruguay.
authors.forename: Maria Victorina
authors.initials: MV
authors.lastname: Lopez-Varela
authors.affiliation: Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
authors.forename: Adriana
authors.initials: A
authors.lastname: Muiño
authors.affiliation: Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Valdivia
authors.affiliation: Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
authors.forename: Carmen
authors.initials: C
authors.lastname: Lisboa
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: José Roberto B
authors.initials: JR
authors.lastname: Jardim
authors.affiliation: Universidad Central de Venezuela, Facultad de Medicina, Caracas, Venezuela.
authors.forename: Maria Montes
authors.initials: MM
authors.lastname: de Oca
authors.affiliation: Universidad Central de Venezuela, Facultad de Medicina, Caracas, Venezuela.
authors.forename: Carlos
authors.initials: C
authors.lastname: Talamo
authors.affiliation: Federal University of Pelotas, Post-graduate Program in Epidemiology, Pelotas, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Bielemann
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Mariana
authors.initials: M
authors.lastname: Gazzotti
authors.affiliation: University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Ruy
authors.initials: R
authors.lastname: Laurenti
authors.affiliation: St. Elizabeth's Medical Center, Pulmonary and Critical Care, Boston, Massachusetts, United States of America.
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Celli
authors.affiliation: Federal University of Pelotas, Post-graduate Program in Epidemiology, Pelotas, Brazil.
authors.forename: Cesar G
authors.initials: CG
authors.lastname: Victora
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology*; D012372:ROC Curve; D013147:Spirometry