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The risk and added values of the atherosclerotic cardiovascular risk enhancers on prediction of cardiovascular events: Tehran lipid and glucose study
- Source :
- Journal of Translational Medicine, Journal of Translational Medicine, Vol 19, Iss 1, Pp 1-14 (2021)
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Background In 2013 American College of Cardiology and the American Heart Association released a guideline on the management of atherosclerotic cardiovascular disease (ASCVD) including a composite of death from CVD, non-fatal myocardial infarction, or non-fatal stroke (hard CVD). This guideline recommended a risk score that was calculated using pooled cohort equations (ASCVD-PCE). The guideline was updated in 2018/2019 and further risk discussion was suggested for deciding whether to continue or initiate statin therapy among non-diabetic individuals with ASCVD-PCE score ranged 5–20%. They recommended a risk discussion with considering risk enhancing factors (ASCVD-REFs) including family history of premature CVD, chronic kidney disease, triglycerides ≥ 175 mg/dl, low-density lipoprotein cholesterol (LDL-C) ≥ 160 mg/dl, metabolic syndrome (Mets), and for women premature menopause, and hypertensive disorders of pregnancy (HDP). In the current study, we aimed to examine the predictability of recommended ASCVD-REFs on incident hard CVD in non-diabetic individuals with LDL-C 70-189 mg/dl, with ASCVD-PCE risk 5–20% during 10 and 15-year follow-up. Methods Among a total of 3546 non-diabetic individuals aged 40-75 years, after excluding those with ASCVD-PCE score Results During the 10-year follow-up, 73 hard CVD events occurred. Although in univariable analysis, high blood pressure (BP) component of Mets, GDM/macrosomia, and HDP remained as significant ASCVD-REFs, in the multivariable analysis, only the history of HDP (5.35 (1.22–23.38)) and GDM/macrosomia (3.18 (1.05–9.65)) showed independent risks. During the 15-year follow-up, Mets (1.47 (1.05–2.06)) and its components of high waist circumference (1.40 (1.0–1.95)) and high BP (1.52 (1.07–2.15)) significantly increased the risk. These ASCVD-REFs did not improve discrimination or predictive ability. Conclusions In a decade follow-up, only conditions specific for women and in longer follow-up, the presence of Mets perse, and its components of high WC and high BP were shown as significant ASCVD-REFs.
- Subjects :
- Adult
medicine.medical_specialty
Risk enhancing factors
lcsh:Medicine
Iran
030204 cardiovascular system & hematology
Risk Assessment
General Biochemistry, Genetics and Molecular Biology
American College of Cardiology
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Humans
030212 general & internal medicine
Myocardial infarction
Family history
Aged
Framingham Risk Score
Proportional hazards model
business.industry
Research
lcsh:R
General Medicine
Guideline
Middle Aged
medicine.disease
Lipids
The American Heart Association
United States
Gestational diabetes
Glucose
Cardiovascular Diseases
Heart Disease Risk Factors
Atherosclerotic cardiovascular disease
Cohort
Female
Metabolic syndrome
business
Subjects
Details
- ISSN :
- 14795876
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Journal of Translational Medicine
- Accession number :
- edsair.doi.dedup.....c07455537471c1b748e79765609ed7f4