1. Astronaut Cardiovascular Health and Risk Modification (Astro-CHARM) Coronary Calcium Atherosclerotic Cardiovascular Disease Risk Calculator
- Author
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Khera, Amit, Budoff, Matthew J, O’Donnell, Christopher J, Ayers, Colby A, Locke, James, de Lemos, James A, Massaro, Joseph M, McClelland, Robyn L, Taylor, Allen, and Levine, Benjamin D
- Subjects
Prevention ,Patient Safety ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Clinical Research ,Atherosclerosis ,Cardiovascular ,Good Health and Well Being ,Adult ,Age Factors ,Aged ,Biomarkers ,C-Reactive Protein ,Coronary Artery Disease ,Decision Support Techniques ,Diabetes Mellitus ,Dyslipidemias ,Female ,Humans ,Hypertension ,Inflammation Mediators ,Internet ,Lipids ,Male ,Middle Aged ,Mobile Applications ,Myocardial Infarction ,Predictive Value of Tests ,Prognosis ,Reproducibility of Results ,Risk Assessment ,Risk Factors ,Sex Factors ,Smoking ,Stroke ,Time Factors ,Vascular Calcification ,calcification of joints and arteries ,coronary vessels ,risk assessment ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences ,Public Health and Health Services ,Cardiovascular System & Hematology - Abstract
BackgroundCoronary artery calcium (CAC) is a powerful novel risk indicator for atherosclerotic cardiovascular disease (ASCVD). Currently, there is no available ASCVD risk prediction tool that integrates traditional risk factors and CAC.MethodsTo develop a CAC ASCVD risk tool for younger individuals in the general population, subjects aged 40 to 65 without prior cardiovascular disease from 3 population-based cohorts were included. Cox proportional hazards models were developed incorporating age, sex, systolic blood pressure, total and high-density lipoprotein cholesterol, smoking, diabetes mellitus, hypertension treatment, family history of myocardial infarction, high-sensitivity C-reactive protein, and CAC scores (Astro-CHARM model [Astronaut Cardiovascular Health and Risk Modification]) as dependent variables and ASCVD (nonfatal/fatal myocardial infarction or stroke) as the outcome. Model performance was assessed internally, and validated externally in a fourth cohort.ResultsThe derivation study comprised 7382 individuals with a mean age 51 years, 45% women, and 55% nonwhite. The median CAC was 0 (25th, 75th [0,9]), and 304 ASCVD events occurred in a median 10.9 years of follow-up. The c-statistic was 0.784 for the risk factor model, and 0.817 for Astro-CHARM ( P
- Published
- 2018