CAROTID ULTRASOUND IDENTIFIES HIGH RISK SUBCLINICAL ATHEROSCLEROSIS IN ADULTS WITH LOW FRAMINGHAM RISK SCORES

Objectives/Hypothesis: Predicting the prognosis of idiopathic sudden sensorineural hearing loss (ISSHL) remains challenging. This investigation aimed to apply Framingham Risk Scores (FRS) to assess the combination of prognostic factors following ISSHL and investigate the predictive role of FRS in patients with multiple comorbidities including hypertension, diabetes, and hyperlipidemia. Study design: Retrospective study. Methods: Twenty-one patients presenting with unilateral idiopathic sudden sensorineural hearing loss and multiple comorbidities were surveyed. Framingham Risk Score was calculated, and patients were assigned into high-risk (FRS ≥20%) and low-risk (FRS <20%) groups. Mean pure tone audiometry (PTA) threshold of both groups and hearing outcomes following established criteria were investigated. All patients were treated with the same protocol of oral methylprednisolone. Results: Overall successful recovery rate (complete + marked recovery) was 23.81%. The mean PTA threshold of the low-risk group showed significant improvement (mean PTA ± standard error, SE: pretreatment, 73.23 ± 11.80; posttreatment, 54.89 ± 10.25, P = .002), while the high-risk group did not show significant improvement in mean PTA threshold (mean PTA ± SE: pretreatment, 71.94 ± 11.77; posttreatment, 68.89 ± 12.81, P = .73). Conclusion: Framingham Risk Scores may be useful in predicting outcomes for ISSHL patients with multiple comorbidities.

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High Prevalence of Subclinical Atherosclerosis by Carotid Ultrasound among Mexican Americans: Discordance with 10-Year Risk Assessment using the Framingham Risk Score

Echocardiography ◽

10.1111/j.1540-8175.2012.01774.x ◽

2012 ◽

Vol 29 (10) ◽

pp. 1224-1232 ◽

Cited By ~ 7

Author(s):

Susan T. Laing ◽

Beverly Smulevitz ◽

Kristina P. Vatcheva ◽

Anne R. Rentfro ◽

David D. McPherson ◽

...

Keyword(s):

Risk Assessment ◽

Risk Score ◽

Mexican Americans ◽

Framingham Risk Score ◽

Subclinical Atherosclerosis ◽

Carotid Ultrasound ◽

Framingham Risk ◽

High Prevalence

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ASSESSMENT OF 10-YEAR RISK OF DEVELOPING A MAJOR CARDIOVASCULAR EVENT IN PATIENTS ATTENDING A HOSPITAL FOR THE TREATMENT OF OTHER DISORDERS

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2020v12i7.37988 ◽

2020 ◽

pp. 74-78

Author(s):

M. MAHIMA SWAROOPA ◽

REDDY PRAVEEN ◽

S. K. LAL SAHEB ◽

S. K. SAI RINNISHA ◽

P. SARANYA ◽

...

Keyword(s):

High Risk ◽

Low Risk ◽

Risk Scores ◽

Intermediate Risk ◽

Total Risk ◽

Cvd Risk ◽

Framingham Risk ◽

Risk Scoring ◽

Ascvd Risk ◽

Risk Estimator

Objective: To assess the individual’s predicted risk of developing a CVD event in 10 y using risk scores among persons with other disorders/diseases. Methods: This is a cross-sectional observational study conducted for a period of 6 mo among 283 subjects. Total risk was estimated individually by using Framingham Risk Scoring Algorithm and ASCVD risk estimator. Results: According to Framingham Risk score the prevalence of low risk (<10%) identified as 67.84% (192), followed by intermediate risk (10%-19%), 19.08% (54), and high risk (≥20%) 13.07% (37). By using ASCVD Risk estimator, risk has reported in our study population was low risk (<5%) is 48.76% (138), borderline risk (5-7.4%) is 13.07% (37), intermediate risk (7.5-19.9%) is about 25.09% (71), high risk (>20%) is about 13.07% (37). Conclusion: In this study burden of CVD risk was relatively low, which was estimated by both the Framingham scale and ASCVD Risk estimator. Risk scoring of individuals helps us to identify the patients at high risk of CV diseases and also helps in providing management strategies.

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Underestimation of Risk of Carotid Subclinical Atherosclerosis by Cardiovascular Risk Scores in Patients with Psoriatic Arthritis

The Journal of Rheumatology ◽

10.3899/jrheum.170025 ◽

2017 ◽

Vol 45 (2) ◽

pp. 218-226 ◽

Cited By ~ 7

Author(s):

Jiayun Shen ◽

Steven H. Lam ◽

Qing Shang ◽

Chun-Kwok Wong ◽

Edmund K. Li ◽

...

Keyword(s):

Psoriatic Arthritis ◽

High Risk ◽

Goodness Of Fit ◽

Disease Risk ◽

Subclinical Atherosclerosis ◽

Cardiovascular Disease Risk ◽

Risk Scores ◽

Atherosclerotic Cardiovascular Disease ◽

Multiplication Factor ◽

Risk Algorithm

Objective.To test the performances of established cardiovascular (CV) risk scores in discriminating subclinical atherosclerosis (SCA) in patients with psoriatic arthritis.Methods.These scores were calculated: Framingham risk score (FRS), QRISK2, Systematic COronary Risk Evaluation (SCORE), 10-year atherosclerotic cardiovascular disease risk algorithm (ASCVD) from the American College of Cardiology and the American Heart Association, and the European League Against Rheumatism (EULAR)–recommended modified versions (by 1.5 multiplication factor, m-). Carotid intima-media thickness > 0.9 mm and/or the presence of plaque determined by ultrasound were classified as SCA+.Results.We recruited 146 patients [49.4 ± 10.2 yrs, male: 90 (61.6%)], of whom 142/137/128/118 patients were eligible to calculate FRS/QRISK2/SCORE/ASCVD. Further, 62 (42.5%) patients were SCA+ and were significantly older, with higher systolic blood pressure and higher low-density lipoprotein cholesterol (all p < 0.05). All CV risk scores were significantly higher in patients with SCA+ [FRS: 7.8 (3.9–16.5) vs 2.7 (1.1–7.8), p < 0.001; QRISK2: 5.5 (3.1–10.2) vs 2.9 (1.2–6.3), p < 0.001; SCORE: 1 (0–2) vs 0 (0–1), p < 0.001; ASCVD: 5.6 (2.6–12.4) vs 3.4 (1.4–6.1), p = 0.001]. The Hosmer-Lemeshow test revealed moderate goodness of fit for the 4 CV scores (p ranged from 0.087 to 0.686). However, of the patients with SCA+, those identified as high risk were only 44.1% (by FRS > 10%), 1.8% (QRISK2 > 20%), 10.9% (SCORE > 5%), and 43.6% (ASCVD > 7.5%). By applying the EULAR multiplication factor, 50.8%/14.3%/14.5%/54.5% of the patients with SCA+ were identified as high risk by m-FRS/m-QRISK2/m-SCORE/m-ASCVD, respectively. EULAR modification increased the sensitivity of FRS and ASCVD in discriminating SCA+ from 44% to 51%, and 44% to 55%, respectively.Conclusion.All CV risk scores underestimated the SCA+ risk. EULAR–recommended modification improved the sensitivity of FRS and ASCVD only to a moderate level.

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Statin Prescriptions for High-Risk Patients Are Increased by Laboratory-Initiated Framingham Risk Scores: A Quality-Improvement Initiative

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2017.02.005 ◽

2017 ◽

Vol 33 (5) ◽

pp. 682-684 ◽

Cited By ~ 4

Author(s):

Christopher Naugler ◽

Charles Cook ◽

Louise Morrin ◽

James Wesenberg ◽

Allison A. Venner ◽

...

Keyword(s):

Quality Improvement ◽

High Risk ◽

Risk Scores ◽

Quality Improvement Initiative ◽

High Risk Patients ◽

Framingham Risk ◽

Risk Patients

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SCORE2 Assessment in the Calculation of Cardiovascular Risk in Patients with Rheumatoid Arthritis

Diagnostics ◽

10.3390/diagnostics11122363 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2363

Author(s):

Iván Ferraz-Amaro ◽

Alfonso Corrales ◽

Belén Atienza-Mateo ◽

Nuria Vegas-Revenga ◽

Diana Prieto-Peña ◽

...

Keyword(s):

High Risk ◽

Carotid Plaque ◽

Subclinical Atherosclerosis ◽

Carotid Ultrasound ◽

Cvd Risk ◽

Predictive Capacity ◽

Spearman's Rho ◽

Spearman’S Rho ◽

Very High ◽

Risk Categories

Patients with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD). Risk chart algorithms, such as the Systematic Coronary Risk Assessment (SCORE), often underestimate the risk of CVD in patients with RA. In this sense, the use of noninvasive tools, such as the carotid ultrasound, has made it possible to identify RA patients at high risk of CVD who had subclinical atherosclerosis disease and who had been included in the low or moderate CVD risk categories when the SCORE risk tables were applied. The 2003 SCORE calculator was recently updated to a new prediction model: SCORE2. This new algorithm improves the identification of individuals from the general population at high risk of developing CVD in Europe. Our objective was to compare the predictive capacity between the original SCORE and the new SCORE2 to identify RA patients with subclinical atherosclerosis and, consequently, high risk of CVD. 1168 non-diabetic patients with RA and age > 40 years were recruited. Subclinical atherosclerosis was searched for by carotid ultrasound. The presence of carotid plaque and the carotid intima media wall thickness (cIMT) were evaluated. SCORE and SCORE2 were also calculated. The relationships of SCORE and SCORE2 to each other and to the presence of subclinical carotid atherosclerosis were studied. The correlation between SCORE and SCORE2 was found to be high in patients with RA (Spearman’s Rho = 0.961, p < 0.001). Both SCORE (Spearman’s Rho = 0.524) and SCORE2 (Spearman’s Rho = 0.521) were similarly correlated with cIMT (p = 0.92). Likewise, both calculators showed significant and comparable discriminations for the presence of carotid plaque: SCORE AUC 0.781 (95%CI 0.755–0.807) and SCORE2 AUC 0.774 (95%CI 0.748–0.801). Using SCORE, 80% and 20% of the patients were in the low or moderate and high or very high CVD risk categories, respectively. However, when the same categories were evaluated using SCORE2, the percentages were different (58% and 42%, respectively). Consequently, the number of RA patients included in the high or very high CVD risk categories was significantly higher with SCORE2 compared to the original SCORE. (p < 0.001). In conclusion, although predictive capacity for the presence of carotid plaque is equivalent between SCORE and SCORE2, SCORE2 identifies a significantly higher proportion of patients with RA who are at high or very high risk of CVD.

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Abstract 19907: Clinical Prediction Risk Scores Systematically Underestimate the Presence and Extent of Subclinical Atherosclerosis in Brazilian Women: The Brazilian Study of Longitudinal Health (ELSA-Brasil)

Circulation ◽

10.1161/circ.130.suppl_2.19907 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Marcio S Bittencourt ◽

Alexandre C Pereira ◽

Henrique L Staniak ◽

Rodolfo Sharovsky ◽

Luz Marina Gomez ◽

...

Keyword(s):

Subclinical Atherosclerosis ◽

Risk Scores ◽

Continuous Part ◽

Clinical Risk ◽

Framingham Risk ◽

Model Probability ◽

Prediction Risk ◽

Multicenter Prospective Study ◽

Few Data ◽

Discrete Part

Introduction: Different scores were developed to predict cardiovascular events in different populations. Due to genetic, social and economical differences, their performances vary according to the population to which they are applied. While there is concern that some scores may underestimate risk in women, few data exist for the Brazilian population. Hypothesis: Clinical risk scores will underestimate the coronary artery calcium (CAC) in Brazilian women. Methods: In a substudy from the ELSA-Brasil, a multicenter prospective study that enrolled civil servants in Brazil, 4546 participants underwent a CAC score. We calculated the Framingham risk score, Reynolds score, ASSIGN, PROCAM and both the low and the high European SCORE. To test the ability of each score to predict CAC values, we used a zero inflated model, which accommodates better CAC distribution. This is a two part model; the discrete part evaluates the association of the predictor with the probability of a CAC=0, and the continuous part of the model evaluates the association of the score with the CAC value. Results: The population included 1868 (55%) women with a mean age of 48±8 years. The median CAC was 0 (range 0 - 5363). In figure 1 we present the association of each score with the CAC values stratified by gender. All score are significantly associated with the discrete part of the model (probability of a CAC=0) (p>0.001). However, while all scores were associated with the continuous part of the model for men (p<0.0001); only the Reynolds (p=0.035) and the high SCORE (p<0.0001) were associated with the continuous part of the model in women, whereas the Framingham score (p=0.96), ASSIGN (p=0.33) and PROCAM (p=0.78) were not. Figure 1 shows the association of each score with the CAC results stratified by gender. Conclusions: In a large Brazilian cohort, all clinical risk scores were significantly associated with the presence of CAC in men, whereas only the SCORE and Reynolds were associated with CAC values in women.

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