scholarly journals Estimating Longitudinal Risks and Benefits From Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool: A Special Report From the American Heart Association and American College of Cardiology

Circulation ◽  
2017 ◽  
Vol 135 (13) ◽  
Author(s):  
Donald M. Lloyd-Jones ◽  
Mark D. Huffman ◽  
Kunal N. Karmali ◽  
Darshak M. Sanghavi ◽  
Janet S. Wright ◽  
...  
Keyword(s):  
Risk Assessment ◽  
American Heart Association ◽  
Assessment Tool ◽  
American Heart ◽  
Heart Association ◽  
Risk Assessment Tool ◽  
Special Report ◽  
Risks And Benefits ◽  
Medicare Patients ◽  
Ascvd Risk

scholarly journals Coronary Artery Calcium for Personalized Allocation of Aspirin in Primary Prevention of Cardiovascular Disease in 2019

Circulation ◽  
2020 ◽  
Vol 141 (19) ◽  
pp. 1541-1553 ◽  
Author(s):  
Miguel Cainzos-Achirica ◽  
Michael D. Miedema ◽  
John W. McEvoy ◽  
Mahmoud Al Rifai ◽  
Philip Greenland ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Relative Risk ◽  
Primary Prevention ◽  
American Heart Association ◽  
Relative Risk Reduction ◽  
American Heart ◽  
Heart Association ◽  
Risk Of Bleeding ◽  
Ascvd Risk

Background: Recent American College of Cardiology/American Heart Association Primary Prevention Guidelines recommended considering low-dose aspirin therapy only among adults 40 to 70 years of age who are at higher atherosclerotic cardiovascular disease (ASCVD) risk but not at high risk of bleeding. However, it remains unclear how these patients are best identified. The present study aimed to assess the value of coronary artery calcium (CAC) for guiding aspirin allocation for primary prevention by using 2019 aspirin meta-analysis data on cardiovascular disease relative risk reduction and bleeding risk. Methods: The study included 6470 participants from the MESA Study (Multi-Ethnic Study of Atherosclerosis). ASCVD risk was estimated using the pooled cohort equations, and 3 strata were defined: <5%, 5% to 20%, and >20%. All participants underwent CAC scoring at baseline, and CAC scores were stratified as =0, 1 to 99, ≥100, and ≥400. A 12% relative risk reduction in cardiovascular disease events was used for the 5-year number needed to treat (NNT 5 ) calculations, and a 42% relative risk increase in major bleeding events was used for the 5-year number needed to harm (NNH 5 ) estimations. Results: Only 5% of MESA participants would qualify for aspirin consideration for primary prevention according to the American College of Cardiology/American Heart Association guidelines and using >20% estimated ASCVD risk to define higher risk. Benefit/harm calculations were restricted to aspirin-naive participants <70 years of age not at high risk of bleeding (n=3540). The overall NNT 5 with aspirin to prevent 1 cardiovascular disease event was 476 and the NNH 5 was 355. The NNT 5 was also greater than or similar to the NNH 5 among estimated ASCVD risk strata. Conversely, CAC≥100 and CAC≥400 identified subgroups in which NNT 5 was lower than NNH 5 . This was true both overall (for CAC≥100, NNT 5 =140 versus NNH 5 =518) and within ASCVD risk strata. Also, CAC=0 identified subgroups in which the NNT 5 was much higher than the NNH 5 (overall, NNT 5 =1190 versus NNH 5 =567). Conclusions: CAC may be superior to the pooled cohort equations to inform the allocation of aspirin in primary prevention. Implementation of current 2019 American College of Cardiology/American Heart Association guideline recommendations together with the use of CAC for further risk assessment may result in a more personalized, safer allocation of aspirin in primary prevention. Confirmation of these findings in experimental settings is needed.

Abstract #1112: Clinical Evaluation of T2D Patients for Cardiovascular Risk Through Million Heart ASCVD Risk Assessment Tool

2017 ◽  
Vol 23 ◽  
pp. 295
Author(s):  
Sanjiv Shah ◽  
Jayaprakash Sai ◽  
Balaji Jaganmohan ◽  
Raja Selvarajan ◽  
S.G. Moazam ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Clinical Evaluation ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Ascvd Risk

scholarly journals A Perspective on the New American College of Cardiology/American Heart Association Guidelines for Cardiovascular Risk Assessment

2014 ◽  
Vol 89 (9) ◽  
pp. 1244-1256 ◽  
Author(s):  
Iftikhar J. Kullo ◽  
Jorge F. Trejo-Gutierrez ◽  
Francisco Lopez-Jimenez ◽  
Randal J. Thomas ◽  
Thomas G. Allison ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cardiovascular Risk ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Cardiovascular Risk Assessment

scholarly journals Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients: A Policy Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (24) ◽  
Author(s):  
Peter K. Henke ◽  
Susan R. Kahn ◽  
Christopher J. Pannucci ◽  
Eric A. Secemksy ◽  
Natalie S. Evans ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
American Heart Association ◽  
American Heart ◽  
Public Awareness ◽  
Heart Association ◽  
Good Evidence ◽  
Hospitalized Patients ◽  
Policy Statement ◽  
Prophylactic Measures

Venous thromboembolism (VTE) is a major preventable disease that affects hospitalized inpatients. Risk stratification and prophylactic measures have good evidence supporting their use, but multiple reasons exist that prevent full adoption, compliance, and efficacy that may underlie the persistence of VTE over the past several decades. This policy statement provides a focused review of VTE, risk scoring systems, prophylaxis, and tracking methods. From this summary, 5 major areas of policy guidance are presented that the American Heart Association believes will lead to better implementation, tracking, and prevention of VTE events. They include performing VTE risk assessment and reporting the level of VTE risk in all hospitalized patients, integrating preventable VTE as a benchmark for hospital comparison and pay-for-performance programs, supporting appropriations to improve public awareness of VTE, tracking VTE nationwide with the use of standardized definitions, and developing a centralized data steward for data tracking on VTE risk assessment, prophylaxis, and rates.

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