Calculation of individual cardiovascular risk in a primary prevention setting shows a high number of patients with a high risk score

2004 ◽  
Vol 93 (5) ◽  
pp. 413-415 ◽  
Author(s):  
S. Kelle ◽  
P. Stawowy ◽  
E. Fleck ◽  
M. Neuss ◽  
M. Roser ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Primary Prevention ◽  
High Risk ◽  
Risk Score ◽  
Number Of Patients

scholarly journals Assessment of cardiovascular risk tools as predictors of cardiovascular disease events in systemic lupus erythematosus

2021 ◽  
Vol 8 (1) ◽  
pp. e000448
Author(s):  
Jagan Sivakumaran ◽  
Paula Harvey ◽  
Ahmed Omar ◽  
Oshrat Tayer-Shifman ◽  
Murray B Urowitz ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Negative Predictive Value ◽  
Risk Score ◽  
Predictive Value ◽  
Framingham Risk Score ◽  
Cvd Risk ◽  
Framingham Risk ◽  
Number Of Patients

BackgroundSLE is an independent risk factor for cardiovascular disease (CVD). This study aimed to determine which among QRISK2, QRISK3, Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS) and SLE Cardiovascular Risk Equation (SLECRE) best predicts CVD.MethodsThis is a single-centre analysis on 1887 patients with SLE followed prospectively according to a standard protocol. Tools’ scores were evaluated against CVD development at/within 10 years for patients with CVD and without CVD. For patients with CVD, the index date for risk score calculation was chosen as close to 10 years prior to CVD event. For patients without CVD, risk scores were calculated as close to 10 years prior to the most recent clinic appointment. Proportions of low-risk (<10%), intermediate-risk (10%–20%) and high-risk (>20%) patients for developing CVD according to each tool were determined, allowing sensitivity, specificity, positive/negative predictive value and concordance (c) statistics analysis.ResultsAmong 1887 patients, 232 CVD events occurred. QRISK2 and FRS, and QRISK3 and mFRS, performed similarly. SLECRE classified the highest number of patients as intermediate and high risk. Sensitivities and specificities were 19% and 93% for QRISK2, 22% and 93% for FRS, 46% and 83% for mFRS, 47% and 78% for QRISK3, and 61% and 64% for SLECRE. Tools were similar in negative predictive value, ranging from 89% (QRISK2) to 92% (SLECRE). FRS and mFRS had the greatest c-statistics (0.73), while QRISK3 and SLECRE had the lowest (0. 67).ConclusionmFRS was superior to FRS and was not outperformed by the QRISK tools. SLECRE had the highest sensitivity but the lowest specificity. mFRS is an SLE-adjusted practical tool with a simple, intuitive scoring system reasonably appropriate for ambulatory settings, with more research needed to develop more accurate CVD risk prediction tools in this population.

Abstract 3264: Remarkable Differences in calculating the Cardiovascular Risk according the Framingham-, Procam- and ESC Risk-Scores. First Results of the DETECT Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Sigmund Silber ◽  
Barbara M Richartz ◽  
Frauke Jarre ◽  
David Pittrow ◽  
Jens Klotsche ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Score ◽  
High Risk Group ◽  
Risk Scores ◽  
Individual Risk ◽  
High Risk Patients ◽  
Number Of Patients ◽  
Risk Patients ◽  
The Individual

The identification of high-risk patients is of utmost importance for an intensive and effective primary prevention program. Currently, three different scores are used to identify high-risk patients: In the USA, the Framingham risk score, in Germany the Procam risk score and in Europe the European Society of Cardiology ESC) recommended ESC risk score. There is, however, little knowledge how these three risk scores compare to each other in the same population. Therefore we calculated the individual risk of 7519 pats with no known cardiovascular disease according to these three scoring systems. In the DETECT study, 55 518 patients in 3188 primary care offices were enrolled. A representative subgroup of 7,519 randomly chosen patients participated in a cohort sub-study. According to the Framingham-Procam- and ESC-Score, the individual 10-year-risk was determined and patients were _ategorized into groups of high, medium or low risk. The mean 10-year cardiovascular risk is estimated by the PROCAM score at 4.4%, with the ESC score at 8.8% and with the Framingham-Score at 11.5%. The number of patients assigned to a group differs most for the high risk group (please see table ). Unexpectedly, major discrepancies were observed in the same pats, if the Framingham, Procam- or ESC score was used, especially in the identification of high-risk pats. Follow-up will show, which of these risk scores will best predict the actual occurrence of cardiovascular events. Results:

scholarly journals Multiple Myeloma Patients Undergoing Carfilzomib: Development and Validation of a Risk Score for Cardiovascular Adverse Events Prediction

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1631
Author(s):  
Anna Astarita ◽  
Giulia Mingrone ◽  
Lorenzo Airale ◽  
Fabrizio Vallelonga ◽  
Michele Covella ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Assessment ◽  
Multiple Myeloma ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Adverse Events ◽  
Risk Score ◽  
Risk Group ◽  
High Risk Group ◽  
Cardiovascular Risk Assessment

Cardiovascular adverse events (CVAEs) are linked to Carfilzomib (CFZ) therapy in multiple myeloma (MM); however, no validated protocols on cardiovascular risk assessment are available. In this prospective study, the effectiveness of the European Myeloma Network protocol (EMN) in cardiovascular risk assessment was investigated, identifying major predictors of CVAEs. From January 2015 to March 2020, 116 MM patients who had indication for CFZ therapy underwent a baseline evaluation (including blood pressure measurements, echocardiography and arterial stiffness estimation) and were prospectively followed. The median age was 64.53 ± 8.42 years old, 56% male. Five baseline independent predictors of CVAEs were identified: office systolic blood pressure, 24-h blood pressure variability, left ventricular hypertrophy, pulse wave velocity value and global longitudinal strain. The resulting ‘CVAEs risk score’ distinguished a low- and a high-risk group, obtaining a negative predicting value for the high-risk group of 90%. 52 patients (44.9%) experienced one or more CVAEs: 17 (14.7%) had major and 45 (38.7%) had hypertension-related events. In conclusion, CVAEs are frequent and a specific management protocol is crucial. The EMN protocol and the risk score proved to be useful to estimate the baseline risk for CVAEs during CFZ therapy, allowing the identification of higher-risk patients.

Finding the High-Risk Patient in Primary Prevention Is Not as Easy as a Conventional Risk Score!

2016 ◽  
Vol 129 (12) ◽  
pp. 1329.e1-1329.e7 ◽  
Author(s):  
John A. Ambrose ◽  
Tushar Acharya ◽  
Micah J. Roberts
Keyword(s):  
Primary Prevention ◽  
High Risk ◽  
Risk Score ◽  
High Risk Patient ◽  
Risk Patient

scholarly journals Prior Use of Medication for Primary Prevention in Patients with Coronary Syndrome

2020 ◽  
Vol 11 ◽  
pp. 215013272094694
Author(s):  
Andrés Gaviria-Mendoza ◽  
Julián Andrés Zapata-Carmona ◽  
Andrés Alirio Restrepo-Bastidas ◽  
Carmen Luisa Betancur-Pulgarín ◽  
Jorge Enrique Machado-Alba
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Risk Score ◽  
High Intensity ◽  
Real Life ◽  
Risk Scores ◽  
Coronary Syndrome ◽  
Cardiovascular Risk Score ◽  
Clinical Records

Background: Cardiovascular disease, especially coronary disease, represents one of the main causes of morbidity and mortality. Objective: To determine the drug prescription profile for primary cardiovascular prevention prior to a first acute coronary syndrome event. Methods: Cross-sectional study. We included adult patients of any sex affiliated with one healthcare insurer of the Colombian Health System, with a diagnosis of a first episode of acute coronary syndrome that occurred during the period of 2015 to 2016. Sociodemographic, clinical and pharmacological variables were evaluated from clinical records. The cardiovascular risk score prior to the event was calculated, and the need for the use of statins and aspirin in primary prevention was defined according to the recommendations of clinical practice guidelines. Results: Clinical records of 322 patients were reviewed with mean age of 61.9 ± 10.8 years, and 77.3% were men. The most frequent comorbidities were dyslipidemia (64.3%), arterial hypertension (62.7%) and diabetes mellitus (30.1%); 22% of the patients were obese, and 33.5% were smokers. The cardiovascular risk score was calculated in 211 patients (65.5%) who had the necessary variables complete. The median 10-year risk according to Framingham risk score was 21.4%, and it was 16.3% according to the American Heart Association. From the 211 patients with risk scores, there were 179 (84.8%) who needed statins (175 of high intensity, 97.8%), and 88 (27.3%) required aspirin as a primary prevention; however, 56 of these patients (31.3%) did not receive any statins, 127 (72.6%) did not receive the high intensity statin they needed, and 38 (43.2% of those with indication) lacked aspirin. Conclusion: Real-life data show that among a group of patients with high cardiovascular risk, a substantial proportion were not receiving medications for primary prevention necessary to reduce their risk and finally suffered an acute coronary event.

scholarly journals POTENTIAL ADVANTAGES ANDBARRIERS OF POLYPILLAND CARDIOVUSCULAR RISK: A NARRATIVE REVIEW

2020 ◽  
Vol 8 (12) ◽  
pp. 104-106
Author(s):  
Indrakshi Basu ◽  
◽  
Suman Kumar Roy ◽  
Keyword(s):  
Cardiovascular Risk ◽  
Chronic Disease ◽  
Primary Prevention ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Narrative Review ◽  
Risk Prevention ◽  
Fixed Dose ◽  
Dose Combination

Comprehensive approaches are followed in chronic disease prevention. Polypharmacy or using fixed dose combination of polypill is an element under the comprehensive approach. This narrative review is carried out in intent to summarise the potential advantages and barriers of using Polypill in cardiovascular risk prevention. There is potential to benefit the high risk group for non communicable diseases in terms of primary prevention but secondary prevention is not certainly indicated. Available Drugs are noted.

scholarly journals Primary Prevention of Cardiovascular Risk in Lithuania—Results from EUROASPIRE V Survey

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 134
Author(s):  
Gediminas Urbonas ◽  
Lina Vencevičienė ◽  
Leonas Valius ◽  
Ieva Krivickienė ◽  
Linas Petrauskas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
High Risk ◽  
Lipid Lowering ◽  
Blood Pressure Target ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Risk Patients ◽  
Very High

Background and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients’ interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%–80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. Many patients did not accurately perceive their own risk of developing CVD.

scholarly journals Association of placental pathology and postpartum cardiovascular risk screening following preeclampsia: an observational cohort study

2021 ◽  
Author(s):  
Samantha Benton ◽  
Erika Mery ◽  
David Grynspan ◽  
Laura Gaudet ◽  
Graeme Smith ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Score ◽  
Observational Cohort Study ◽  
Cvd Risk ◽  
Risk Screening ◽  
Cardiovascular Screening ◽  
Increased Risk ◽  
Observational Cohort

Objective: To determine the association between placental lesions and lifetime cardiovascular disease (CVD) risk screening at 6 months postpartum following preeclampsia (PE). Design: Observational cohort study. Setting: Tertiary care centres in Ottawa and Kingston, Ontario, Canada. Population: Women diagnosed with PE who received cardiovascular screening at 6 months postpartum. Methods: Placentas from women diagnosed with PE were evaluated for histopathological lesions according to a standardised synoptic data collection form with blinding to clinical outcomes apart from gestational age at delivery. At 6 months postpartum, each participant was screened for cardiovascular risk factors and a lifetime cardiovascular risk score was calculated. A risk score >35% was deemed high risk for lifetime CVD. Main Outcome Measures: The association between placental lesions and lifetime CVD risk was assessed using odds ratios (OR, 95% confidence intervals). Results: Of the 85 participants, 53 (62.4%) screened high-risk for lifetime CVD. High-risk women had more severe lesions of maternal vascular malperfusion (MVM). MVM lesions with a severity score >2 resulted in a 3-fold increased risk of screening high risk for lifetime CVD (OR 3.10 [1.20-7.92]). MVM lesion score >2 was moderately predictive of high-risk screening (AUC 0.63 [0.51,0.75]; sensitivity: 71.8% [54.6,84.4]; specificity: 54.7% [41.5,67.3]). When clinical data was added, the model’s predictive performance improved (AUC 0.73 [0.62,0.84] sensitivity 78.4% [65.4,87.5]; specificity 51.6% [34.8,68.0]). Conclusions: PE women with MVM are more likely to screen high-risk for lifetime CVD compared to women without these lesions. Placenta pathology may provide a unique modality to identify women for postpartum cardiovascular screening.

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