scholarly journals COMPARISON OF A FRAILTY INDEX WITH CARDIOVASCULAR RISK SCORES IN PREDICTING CARDIOVASCULAR DISEASE MORTALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S800-S800
Author(s):  
Dustin S Kehler ◽  
Olga Theou ◽  
Kenneth Rockwood
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Mortality Risk ◽  
Disease Risk ◽  
Frailty Index ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Cvd Mortality

Abstract We compared the predictive and discriminative ability of frailty with traditional cardiovascular risk scores to estimate 10-year cardiovascular disease (CVD) mortality risk. Individuals aged 20-79 years old from the National Health and Nutrition Examination Survey who were free from CVD were included (n= 32,066). A 33-item frailty index (FI) which excluded CVD and diabetes-related variables was calculated. We calculated the Framingham Disease Risk (FDR) Hard Coronary Heart Disease and General CVD risk scores, the American Heart Association/American College of Cardiology (AHA/ACC) atherosclerotic cardiovascular disease risk equation, and the European Systematic Coronary Risk Estimation tool. A total of 322 individuals died (1.0%) from CVD. There was a low correlation between the FI and CVD risk scores (spearman’s r= 0.19-0.33; p<0.0001) and a weak to strong correlation between CVD risk scores (spearman’s r=0.19-0.88; p<0.0001). The competing-risks hazard ratio for CVD mortality for every 1% increase in the FI was 1.040 (95% CI: 1.032-1.048; p<0.0001) in an age and sex-adjusted model. The FI was independently predictive of CVD mortality when the other CVD risk scores were added to the model. The area under the receiving operating characteristic (ROC) curve was 0.800 (95% CI: 0.789-0.808; p<0.0001) for the FI. ROC values for the CVD risk scores ranged from 0.710 (95% CI: 0.700-0.721; p<0.0001) for the AHA/ACC risk score to 0.779 (95% CI: 0.770-0.789; p<0.0001) for the FDR General CVD risk score. An FI calculated with non-CVD and diabetes variables can predict 10-year CVD mortality risk independently of traditional CVD risk scores.

scholarly journals Baseline 10-Year Cardiovascular Risk Scores Predict Cognitive Function in Older Persons, and Particularly Women, Living With Human Immunodeficiency Virus Infection

2020 ◽  
Author(s):  
Felicia C Chow ◽  
Asya Lyass ◽  
Taylor F Mahoney ◽  
Joseph M Massaro ◽  
Virginia A Triant ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Human Immunodeficiency Virus ◽  
Cardiovascular Risk ◽  
Cognitive Function ◽  
Risk Score ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Composite Effect ◽  
Immunodeficiency Virus ◽  
Ascvd Risk

Abstract Background Cardiovascular disease (CVD) and associated comorbidities increase the risk of cognitive impairment in persons living with human immunodeficiency virus (PLWH). Given the potential composite effect of multiple cardiovascular risk factors on cognition, we examined the ability of the Atherosclerotic Cardiovascular Disease (ASCVD) risk score and the Framingham Heart Study Global CVD risk score (FRS) to predict future cognitive function in older PLWH. Methods We constructed linear regression models evaluating the association between baseline 10-year cardiovascular risk scores and cognitive function (measured by a summary z-score, the NPZ-4) at a year 4 follow-up visit. Results Among 988 participants (mean age, 52 years; 20% women), mean 10-year ASCVD risk score at entry into the cohort was 6.8% (standard deviation [SD], 7.1%) and FRS was 13.1% (SD, 10.7%). In models adjusted only for cognitive function at entry, the ASCVD risk score significantly predicted year 4 NPZ-4 in the entire cohort and after stratification by sex (for every 1% higher ASCVD risk, year 4 NPZ-4 was lower by 0.84 [SD, 0.28] overall, P = .003; lower by 2.17 [SD, 0.67] in women, P = .001; lower by 0.78 [SD, 0.32] in men, P = .016). A similar relationship was observed between FRS and year 4 NPZ-4. In multivariable models, higher 10-year ASCVD risk and FRS predicted lower NPZ-4 in women. Conclusions Baseline 10-year ASCVD risk and FRS predicted future cognitive function in older PLWH with well-controlled infection. Cardiovascular risk scores may help to identify PLWH, especially women, who are at risk for worse cognition over time.

Abstract MP53: The Impact of the Obesity Epidemic on Atherosclerotic Cardiovascular Disease Risk Scores: The CARDIA Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Duke Appiah ◽  
Pamela J Schreiner ◽  
Raegan W Durant ◽  
Sharina D Person ◽  
Catarina I Kiefe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Disease Risk ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Obesity Epidemic ◽  
Ascvd Risk ◽  
The Impact

Introduction: Cardiovascular disease (CVD) mortality has decreased over recent decades, in part, due to changes in the prevalence of risk factors. However, few studies have explored the impact of the obesity epidemic on CVD risk prediction in young adults. Hypothesis: We assessed the hypothesis that BMI trends are positively associated with changes in 10-year AHA/ACC atherosclerotic cardiovascular disease (ASCVD) risk scores from young adulthood to middle age beyond the effect of other CVD risk factors included in the scores (age, sex, race, lipids, blood pressure, hypertension medication, diabetes, smoking). METHODS: Data were obtained from 2437 black and white men and women aged 18-30 years at baseline (1985-1986) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study with follow-up exams at year 0, 5, 10, 15, 20 and 25 (ages 43-55 years). Repeated-measures regression was used to model the association between ASCVD risk scores and time-varying BMI measures. RESULTS: The average 10-year ASCVD risk increased from 0.6% at baseline (mean age: 25.3) to 3.9% at year 25 (mean age: 50.3) with the change higher for men (blacks: 1.0 to 8.2%, whites: 0.3 to 4.6%) than women (blacks: 0.5 to 3.6%, whites: 1.2 to 1.4%). The overall prevalence of obesity at baseline and year 25 was 10% and 42% respectively. BMI trends were positively associated with 10-year change in ASCVD risk scores (0.12% per 1 kg/m2 increase, p<0.001). BMI adjustment minimally reduced risk scores trends with the greatest change between unadjusted and adjusted risk scores observed among black women (0.1 to 3.0%) (Figures A and B). CONCLUSION: In young adults, BMI trends are associated positively with 10-year changes in ASCVD risk independent of other risk factors. This adds to the evidence that weight control in early adulthood is an important predictor of lower future CVD risk.

Abstract 024: Effects Of Diet On 10-year Atherosclerotic Cardiovascular Disease Risk Using The Pooled Cohort Equations Risk Calculator: Results From The Dash Trial

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Sun Young Jeong ◽  
Lara Kovell ◽  
Timothy B Plante ◽  
Christina C Wee ◽  
Edgar R Miller ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Risk ◽  
Control Diet ◽  
Cardiovascular Disease Risk ◽  
Hdl Cholesterol ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Dash Diet ◽  
Ascvd Risk

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort estimating equation has not been reported. Objective: To determine the effects of adopting the DASH diet on 10-year atherosclerotic cardiovascular disease (ASCVD) risk compared to a typical American (control) diet or a diet rich fruit and vegetables (F/V), but otherwise similar to control. Methods: The DASH trial was a 3-arm, parallel-group, randomized controlled feeding trial of 459 adults aged 22 to 75 years without CVD and not taking anti-hypertensive or diabetes medications. These participants were randomized to a control diet, a F/V diet, or the DASH diet for 8 weeks. Weight was kept constant. Blood pressure (BP) and lipids were measured at baseline and at 8-weeks to compare 10-year ASCVD risk scores across dietary assignments. Comparisons were performed via linear regression adjusted for baseline ASCVD risk score. Results: The mean age of participants was 45 years; 49% were women, 60% were black, and 10% were current smokers. Mean systolic BP was 131.3±10.8 mm Hg, mean LDL cholesterol was 121±32 mg/dL, and mean HDL cholesterol was 48±14 mg/dL. Both DASH and F/V diets shifted the distribution of ASCVD risk scores downward compared to the control diet ( Figure, Panel A ). Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk by 10.0% (95% CI: -17.7, -1.5; P = 0.02) and 11.7% (95% CI: -19.3, -3.3; P = 0.007) respectively ( Figure, Panel B ). There was no difference between the DASH and F/V diets (-1.9%; 95% CI: -10.3, 7.4; P = 0.68). Conclusions: Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk, while the DASH and F/V had similar effects.

scholarly journals A newly developed and externally validated non-clinical score accurately predicts 10-year cardiovascular disease risk in the general adult population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Catarina Schiborn ◽  
Tilman Kühn ◽  
Kristin Mühlenbruch ◽  
Olga Kuxhaus ◽  
Cornelia Weikert ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
Prediction Models ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Clinical Score ◽  
Risk Scores ◽  
Clinical Parameters ◽  
Cvd Risk ◽  
Clinical Scores

AbstractInclusion of clinical parameters limits the application of most cardiovascular disease (CVD) prediction models to clinical settings. We developed and externally validated a non-clinical CVD risk score with a clinical extension and compared the performance to established CVD risk scores. We derived the scores predicting CVD (non-fatal and fatal myocardial infarction and stroke) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (n = 25,992, cases = 683) using competing risk models and externally validated in EPIC-Heidelberg (n = 23,529, cases = 692). Performance was assessed by C-indices, calibration plots, and expected-to-observed ratios and compared to a non-clinical model, the Pooled Cohort Equation, Framingham CVD Risk Scores (FRS), PROCAM scores, and the Systematic Coronary Risk Evaluation (SCORE). Our non-clinical score included age, gender, waist circumference, smoking, hypertension, type 2 diabetes, CVD family history, and dietary parameters. C-indices consistently indicated good discrimination (EPIC-Potsdam 0.786, EPIC-Heidelberg 0.762) comparable to established clinical scores (thereof highest, FRS: EPIC-Potsdam 0.781, EPIC-Heidelberg 0.764). Additional clinical parameters slightly improved discrimination (EPIC-Potsdam 0.796, EPIC-Heidelberg 0.769). Calibration plots indicated very good calibration with minor overestimation in the highest decile of predicted risk. The developed non-clinical 10-year CVD risk score shows comparable discrimination to established clinical scores, allowing assessment of individual CVD risk in physician-independent settings.

scholarly journals Circulating Proangiogenic Cell Activity Is Associated with Cardiovascular Disease Risk

2012 ◽  
Vol 17 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Kreton Mavromatis ◽  
Konstantinos Aznaouridis ◽  
Ibhar Al Mheid ◽  
Emir Veledar ◽  
Saurabh Dhawan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Bone Marrow ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cell Activity ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
The Relationship

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.

Thirty-year cardiovascular risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives

2018 ◽  
Vol 53 (7) ◽  
pp. 651-662 ◽  
Author(s):  
Klara Coello ◽  
Hanne L Kjærstad ◽  
Sharleny Stanislaus ◽  
Sigurd Melbye ◽  
Maria Faurholt-Jepsen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bipolar Disorder ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Newly Diagnosed ◽  
Healthy Individuals ◽  
First Degree Relatives ◽  
Age And Sex

Objectives: Bipolar disorder is associated with a decreased life expectancy of 8–12 years. Cardiovascular disease is the leading cause of excess mortality. For the first time, we investigated the Framingham 30-year risk score of cardiovascular disease in patients with newly diagnosed/first-episode bipolar disorder, their unaffected first-degree relatives and healthy individuals. Methods: In a cross-sectional study, we compared the Framingham 30-year risk score of cardiovascular disease in 221 patients with newly diagnosed/first-episode bipolar disorder, 50 of their unaffected first-degree relatives and 119 healthy age- and sex-matched individuals with no personal or first-degree family history of affective disorder. Among patients with bipolar disorder, we further investigated medication- and illness-related variables associated with cardiovascular risk. Results: The 30-year risk of cardiovascular disease was 98.5% higher in patients with bipolar disorder ( p = 0.017) and 85.4% higher in unaffected first-degree relatives ( p = 0.042) compared with healthy individuals in models adjusted for age and sex. When categorizing participants in low cardiovascular risk without considering age and sex distribution among participants, 81% of patients were at low risk, versus 92% of unaffected relatives and 89% of healthy individuals. Of the patients 209 (94.6%) were diagnosed within the preceding 2 years. Smoking was more prevalent among patients with bipolar disorder (45.2%) and their unaffected first-degree relatives (20.4%) compared with healthy individuals (12.8%). Similarly, dyslipidemia was more common among patients with bipolar disorder compared with healthy individuals. Treatment with psychotropic medication with metabolic adverse effects was associated with higher 30-year cardiovascular disease risk score, whereas we did not find illness-related variables associated with cardiovascular risk among patients with bipolar disorder. Conclusion: We found an enhanced cardiovascular disease risk score in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives, which points to a need for specific primary preventive interventions against smoking and dyslipidemia in these populations.

scholarly journals Development and Validation of a Novel Dementia Risk Score in the UK Biobank Cohort

2021 ◽  
Author(s):  
Melis Anatürk ◽  
Raihaan Patel ◽  
Georgios Georgiopoulos ◽  
Danielle Newby ◽  
Anya Topiwala ◽  
...  
Keyword(s):  
At Risk ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Risk Index ◽  
Risk Scores ◽  
Uk Biobank ◽  
Dementia Risk ◽  
History Of ◽  
The Uk

INTRODUCTION: Current prognostic models of dementia have had limited success in consistently identifying at-risk individuals. We aimed to develop and validate a novel dementia risk score (DRS) using the UK Biobank cohort.METHODS: After randomly dividing the sample into a training (n=166,487, 80%) and test set (n=41,621, 20%), logistic LASSO regression and standard logistic regression were used to develop the UKB-DRS.RESULTS: The score consisted of age, sex, education, apolipoprotein E4 genotype, a history of diabetes, stroke, and depression, and a family history of dementia. The UKB-DRS had good-to-strong discrimination accuracy in the UKB hold-out sample (AUC [95%CI]=0.79 [0.77, 0.82]) and in an external dataset (Whitehall II cohort, AUC [95%CI]=0.83 [0.79,0.87]). The UKB-DRS also significantly outperformed four published risk scores (i.e., Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia score (CAIDE), Dementia Risk Score (DRS), and the Framingham Cardiovascular Risk Score (FRS) across both test sets.CONCLUSION: The UKB-DRS represents a novel easy-to-use tool that could be used for routine care or targeted selection of at-risk individuals into clinical trials.

Abstract 15997: Pooled Cohort Risk Equations: A Comparison of Their Predictions With Five Other Cardiovascular Risk Scores in Five Peruvian Sites

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Juan Bazo-Alvarez ◽  
Frank Peralta-Alvarez ◽  
Renato Quispe ◽  
Julio Poterico ◽  
Giancarlo Valle ◽  
...  
Keyword(s):  
Risk Score ◽  
Disease Risk ◽  
Heart Association ◽  
Population Based ◽  
Continuous Variable ◽  
World Health ◽  
Risk Scores ◽  
Cvd Risk ◽  
Low Middle Income Countries ◽  
Predicted Risk

Introduction: Cardiovascular disease (CVD) risk scores are used to estimate an individual’s risk of developing a disease or death from a cardiovascular event. Recently, the American College of Cardiology/American Heart Association (ACC/AHA) introduced the Pooled Cohort risk equations (ACC/AHA model). It is important to know how comparable CVD risk predictions are in low-middle income countries (LMIC). Hypothesis: ACC/AHA model has a poor concordance with any other CVD risk score. Methods: We used secondary data from two Peruvian, age and sex-matched, population-based studies across five geographical sites. The ACC/AHA model was compared to five other CVD risk prediction tools: two versions of the Framingham Risk Score (FRS-Lipids and FRS-BMI), Reynolds Risk Score (RRS), four versions of the Systematic Coronary Risk Evaluation (SCORE 1-4), World Health Organization risk chart (WHO), and Lancet Chronic Disease risk chart (LCD). We calculated predicted risk as a continuous variable and used Lin’s concordance correlation coefficient (CCC). We also compared the high predicted risk prevalence between all the scores using the cut-off levels suggested by each score’s guidelines. Results: We included 2183 subjects in the risk scores age range of 45-65 years (mean age 54.3 (SD±5.6) years). CCC agreement values found in this study were generally poor. The highest concordance was observed between the ACC/AHA model and the risk scores derived from the Framingham Study (40% with FRS-BMI and 44% with FRS-Lipids). ACC/AHA model depicted the highest proportion of people with predicted high-risk of 10-year CVD, at 29.0% (95%CI 26.9-31.0%) and the same tendency was observed in all study sites. Conclusions: In Peruvian population-based samples, agreement between ACC/AHA model and five other CVD risk scores was generally poor. There is an urgent need to use an appropriate risk score for CVD in LMIC. In an ideal scenario, it would be significant to have a proper CVD risk score for LMIC.

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