Abstract P320: Discordance of Framingham Risk Score and Reynolds Risk Score to Global Vascular Risk Score: Results from the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Molly Jung ◽  
Hector M Medina ◽  
Martha Daviglus ◽  
Marina DelRios ◽  
Mario Garcia ◽  
...  
Keyword(s):  
Family History ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Demographic Characteristics ◽  
Vascular Risk ◽  
Framingham Risk ◽  
Chd Risk ◽  
History Of ◽  
Reynolds Risk Score

Introduction: The Framingham Risk Score (FRS) is a coronary heart disease (CHD) risk model established using an ethnically homogeneous population that predicts 10-year hard CHD events, myocardial infarction (MI) and coronary death. The Reynolds Risk Score (RRS) and Global Vascular Risk Score (GVRS) are validated CHD risk models that, in addition to hard CHD events, predict stroke and other CHD outcomes. In addition to major CHD risk factors, RRS adds systemic inflammation and family history of MI as GVRS adds behavioral and anthropometric measures. This study aims to compare agreement of RRS and GVRS with FRS among Hispanic/Latino adults and to describe discordance in RRS and GVRS with FRS categories, by socio-demographic characteristics. Methods: HCHS/SOL is a population-based cohort study of Hispanics/Latinos in four US communities. The analytic sample includes 6,058 non-diabetic participants 45-74 years of age with no past history of CHD and stroke who underwent comprehensive baseline examination. 10-year hard CHD risk score was calculated; participants were categorized as low (<10%), moderate (10-<20%), and high (≥20%) risk. Kappa scores were calculated to compare agreement of RRS and GVRS with FRS. Socio-demographic characteristics of concordance and discordance were characterized overall; multinomial logistic regression models was used to examine age-sex-adjusted likelihood of in discordance by these factors. Results: Mean age of the participants was 55 (SE=0.15) years, 54.3% were women, 41% had family history of CHD, and 90% were foreign born. Overall, 4,805 (74%) had low FRS, 1,143 (24%) had moderate FRS, and 110 (2%) had high FRS. There was poor agreement between RRS and FRS (Kappa=0.16, P<0.01) and fair agreement between GVRS and FRS (Kappa=0.36, P<0.01). In age-sex-adjusted analyses, RRS and GVRS were both more likely to classify persons of moderate and high risk who are between the ages of 60-74; GVRS classified more moderate and high risk women than the FRS. RRS and GVRS discordance with FRS was not associated with nativity and length of time in US. Conclusion: Significant discordance was observed between RRS and GVRS compared to FRS. Among Hispanic/Latino adults, use of RRS or GVRS may be more inclusive in classifying older age adults and women at high 10-year CHD risk.

scholarly journals Waist:height ratio: a superior index in estimating cardiovascular risks in Turkish adults

2013 ◽  
Vol 17 (10) ◽  
pp. 2246-2252 ◽  
Author(s):  
Reci Meseri ◽  
Reyhan Ucku ◽  
Belgin Unal
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Undiagnosed Diabetes ◽  
Anthropometric Measurement ◽  
Cardiovascular Risks ◽  
Framingham Risk ◽  
Chd Risk ◽  
Diabetes Status

AbstractObjectiveTo determine the best anthropometric measurement among waist: height ratio (WHtR), BMI, waist:hip ratio (WHR) and waist circumference (WC) associated with high CHD risk in adults and to define the optimal cut-off point for WHtR.DesignPopulation-based cross-sectional study.SettingBalcova, Izmir, Turkey.SubjectsIndividuals (n 10 878) who participated in the baseline survey of the Heart of Balcova Project. For each participant, 10-year coronary event risk (Framingham risk score) was calculated using data on age, sex, smoking status, blood pressure, serum lipids and diabetes status. Participants who had risk higher than 10 % were defined as ‘medium or high risk’.ResultsAmong the participants, 67·7 % were female, 38·2 % were obese, 24·5 % had high blood pressure, 9·2 % had diabetes, 1·5 % had undiagnosed diabetes (≥126 mg/dl), 22·0 % had high total cholesterol and 45·9 % had low HDL-cholesterol. According to Framingham risk score, 32·7 % of them had a risk score higher than 10 %. Those who had medium or high risk had significantly higher mean BMI, WHtR, WHR and WC compared with those at low risk. According to receiver-operating characteristic curves, WHtR was the best and BMI was the worst indicator of CHD risk for both sexes. For both men and women, 0·55 was the optimal cut-off point for WHtR for CHD risk.ConclusionsBMI should not be used alone for evaluating obesity when estimating cardiometabolic risks. WHtR was found to be a successful measurement for determining cardiovascular risks. A cut-off point of ‘0·5’ can be used for categorizing WHtR in order to target people at high CHD risk for preventive actions.

Who Gets Inhibitors? Predicting Inhibitory Antibodies in Children with Severe Hemophilia A.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1158-1158
Author(s):  
Petra C. ter Avest ◽  
Kathelijn Fischer ◽  
Elena Santagostino ◽  
Marijke H. van den Berg ◽  
Johanna G. van der Bom
Keyword(s):  
Family History ◽  
High Risk ◽  
Risk Score ◽  
Hemophilia A ◽  
Positive Family History ◽  
Treatment Strategies ◽  
Intensive Treatment ◽  
Severe Hemophilia ◽  
Inhibitor Development ◽  
History Of

Abstract Background. Replacement therapy in severe hemophilia A patients is complicated by formation of inhibitors in around 25% of children. Identification of patients at the highest risk may help to tailor personalized treatment strategies. Objectives. To develop a scoring system that may be used to identify patients at the highest risk of inhibitor development at first treatment. Methods. We used the data from a retrospective multicentre cohort study (the Canal cohort) of patients with severe hemophilia A (factor VIII (FVIII)less than 0.01 IU/ml), born 1990–2000, followed at least until their 50th exposure day. Presence of inhibitor was defined as twice a positive inhibitor titer and a decreased FVIII recovery. Based on the coefficients of a logistic regression model, a weighted risk-score was developed. Shrinkage of regression coefficients was used to control for overfitting. The discriminative ability of the risk-score was expressed as the area under the curve (AUC) of a receiver operating characteristic curve. Results. Out of the 366 patients from the Canal cohort, 284 children were selected of whom 78 developed an inhibitor (27%). Logistic regression analysis revealed 3 independent risk factors for inhibitor development: positive family history, intensive treatment (at least 5 consecutive days) at the first FVIII exposure, and high risk FVIII gene mutations. Table 1 presents odds ratios of the uni- and multivariate analyses, and the risk score. The AUC for the risk-score was 0,724. Table 2 shows that the model is able to separate high and low risk patients from patients with an intermediate risk of 25%. Conclusions. The risk score includes positive family history of inhibitors, high risk factor VIII gene mutation and intensive treatment at first FVIII exposure. This risk score can recognize patients with a doubled risk for inhibitor development and may be used to guide inhibitor preventive treatment strategies. Table 1. Uni- and Multivariate analysis and risk-score. OR (CI), Univariate OR (CI), Multivariate p-value Risk-Score CI = confidence interval 95% Positive Family History of Inhibitors 4.0 (1.7–9.4) 3.0 (1.2–7.7) ,022 3 High risk FVIII Gene Mutation 3.6 (1.8–7.2) 3.7 (1.8–7.9) ,001 4 Intensive Treatment at 1st FVIII exposure 6.8 (3.6–12.9) 7.2 (3.4–15.1) ,000 6 Table 2. Calibration of the risk-score. Model Total n° patients Predicted n° Inhibitors Observed n° Inhibitors Positive Predictive Value Negative Predictive Value LR= Low Risk, MR= Medium Risk, HR= High risk LR:0 72 7 6 0,34 0,92 MR:3–4 153 39 38 0,25 0,69 HR: >4 59 32 34 0,58 0,80

scholarly journals Prediksi Tingkat Risiko Penyakit Kardiovaskuler Aterosklerotik pada Pasien yang Berobat di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Engelin E. Emor ◽  
Agnes L. Panda ◽  
Janry Pangemanan
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Low Risk ◽  
Risk Level ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cross Sectional ◽  
Framingham Risk

Abstract: Atherosclerotic cardiovascular disease is caused by the accumulation of plaque on the artery wall causing dysfunction of anatomical and hemodynamic system of the heart and blood flow. There are many risk factors that cause atherosclerotic cardiovascular disease which are divided into modifiable and unmodifiable risk factors. Prevention of this disease can be achieved with early detection, such as prediction the risk level of 10 years ahead of atherosclerotic cardiovascular disease by using the Framingham Risk Score (FRS). This study was aimed to obtain the risk level of atherosclerotic cardiovascular disease in patients at Internal Medicine Polyclinic of Prof. Dr. R. D. Kandou Hospital Manado by using their medical records from September to October 2017. This was a descriptive study with a cross sectional design. There were 100 samples obtained by using conclusive sampling technique. Of the 100 patients, 42 (42%) patients had low risk, 27 (27%) patients had moderate risk, and 31 (31%) patients had high risk of atherosclerotic cardiovascular disease in 10 years ahead. Conclusion: In this study, the highest percentage was in patients with low risk, followed by patients with high risk, and moderate risk.Keywords: ASCVD, Framingham Risk Score, Risk of atherosclerotic cardiovascular sisease. Abstrak: Penyakit kardiovaskuler aterosklerotik adalah penyakit yang disebabkan oleh adanya timbunan plak pada dinding arteri sehingga menyebabkan gangguan fungsional, anatomis serta sistem hemodinamis jantung dan pembuluh darah. Terdapat banyak faktor risiko yang menyebabkan terjadinya penyakit kardiovaskuler aterosklerotik yang dibagi menjadi faktor risiko yang dapat dimodifikasi dan yang tidak dapat dimodifikasi. Pencegahan penyakit ini dapat dilakukan dengan deteksi dini, salah satunya yaitu dengan memrediksi tingkat risiko 10 tahun kedepan terjadinya penyakit kardiovaskuler aterosklerotik dengan menggunakan Framingham Risk Score. Penelitian ini bertujuan untuk mengetahui tingkat risiko penyakit kardiovaskuler ateroskerotik pada pasien di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang menggunakan data rekam medik pasien Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado periode September - Oktober 2017. Sampel penelitian berjumlah 100 orang dengan teknik pengambilan conclusive sampling. Terdapat 42 pasien (42%) dengan tingkat risiko rendah, 27 pasien (27%) dengan risiko sedang, dan 31 pasien (31%) dengan risiko tinggi terkena penyakit kardiovaskuler aterosklerotik 10 tahun kedepan. Simpulan: Pada studi ini, persentase tertinggi ialah pasien dengan tingkat risiko rendah terjadinya penyakit kardiovaskuler aterosklerotik, diikuti tingkat risiko tinggi dan risiko sedang.Kata kunci: ASCVD, Framingham Risk Score, tingkat risiko penyakit kardiovaskuler aterosklerotik

Framingham risk score after risk-reducing salpingo-oophorectomy in women at risk for hereditary breast ovarian cancer: A controlled observational study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 11048-11048
Author(s):  
T. M. Michelsen ◽  
S. Tonstad ◽  
A. A. Dahl ◽  
A. H. Pripp ◽  
C. G. Tropé ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Genetic Counseling ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Risk Profile ◽  
Hereditary Breast Ovarian Cancer ◽  
Framingham Risk ◽  
Chd Risk ◽  
Risk Reducing

11048 Background: Risk-reducing salpingo-oophorectomy (RRSO) effectively prevents ovarian cancer in BRCA mutation carriers and in women at risk for hereditary breast-ovarian cancer. RRSO induces immediate menopause, which may increase the risk of coronary heart disease (CHD). Our aim was to determine CHD risk using Framingham risk score and examine factors associated with this risk in women who had undergone RRSO compared to population-based controls. Methods: A sample of 326 (65% of invited) women who underwent RRSO after genetic counseling from 1980–2005 provided completed questionnaires, physical measures, and blood samples. Controls were 1,630 age-matched controls from the Norwegian Nord-Trøndelag Health Study (HUNT-2) (1995- 97). Results: Mean age in both the RRSO and control groups at survey was 54.4 years. Mean follow-up after surgery was 6.5 years (SD 4.4). The RRSO group had a more favorable CHD risk profile (higher education, more physical activity, less smoking, lower total cholesterol, higher HDL cholesterol, lower systolic blood pressure and lower BMI) and lower Framingham total score compared to controls (p<0.05). In multiple logistic regression analyses RRSO was inversely associated with Framingham 10-year risk ≥5% (Odds Ratio 0.49, 95% CI [0.34, 0.71] p<0.001). Conclusions: In contrast to expectation, women at increased risk of hereditary breast ovarian cancer had a favorable CHD risk profile after RRSO compared to age-matched controls from the general population, and RRSO was associated with lower Framingham risk score. Follow-up time, self-selection of women seeking genetic counseling, changes in lifestyle after surgery and survival bias are possible explanations of this finding. No significant financial relationships to disclose.

Abstract 2223: Carotid Intima Media Thickness Progression is Modest in Statin-Treated Familial Hypercholesterolemia Patients - Results from a Patient Level Meta-Analysis of 1257 Patients

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Menno Vergeer ◽  
Rong Zhou ◽  
Raphael Duivenvoorden ◽  
Joerg Koglin ◽  
Yale B Mitchel ◽  
...  
Keyword(s):  
Familial Hypercholesterolemia ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
High Dose ◽  
Media Thickness ◽  
Framingham Risk ◽  
History Of ◽  
Change In Mean

In the past, patients with heterozygous familial hypercholesterolemia (HeFH) were believed to be an ideal population to study changes in carotid intima media thickness (cIMT) based on their aggressive lipid disorder and high incidence of atherosclerotic events. However, following publication of recent cIMT trials in this population, the feasibility of demonstrating a reduction of cIMT progression in statin-treated HeFH patients has come under scrutiny. To inform future study designs, we evaluated cIMT progression and baseline predictors of cIMT progression (change in mean cIMT for all segments and common carotid artery (CCA) cIMT over 1 and 2 years), in merged data of 1257 patients from the statin arms of the ASAP, RADIANCE 1, CAPTIVATE and ENHANCE studies and performed backward regression analyses with prespecified co-variates. Based on this analysis, bootstrap analyses were performed to estimate cIMT progression for various hypothetical in- and exclusion criteria. For all studies combined, 2-year mean cIMT progression was 0.0102 ± 0.1348 mm. Positive predictors of this progression were prior use of high dose statins and use of other lipid-modifying therapy. Positive predictors of 1-year mean cIMT progression and 1 & 2 year CCA cIMT progression were age, history of hypertension, Framingham risk score, female gender, high dose statin use and history of CAD; negative predictors were screening LDL-C and ApoA-I. In simulations, HeFH patients previously taking statin and over 50 years of age had an estimated 2-year mean cIMT progression of 0.0216 ± 0.155 mm (based on n = 380). Two year progression for patients with a history of CAD or a Framingham risk score ≥ 10 would be estimated at 0.0197 ± 0.158 mm (based on n = 334). This study shows that cIMT progression in a contemporary HeFH patient population is substantially lower than anticipated, limiting the usefulness of cIMT studies to test new therapies in this population. While focus on individual subgroups characterized by population-specific predictors of cIMT progression results in slightly higher cIMT progression, the current analysis suggests that other patient populations should be considered for future cIMT studies.

Framingham Risk Score as a Prognostic Predictor of Sudden Sensorineural Hearing Loss: A Preliminary Study

2017 ◽  
Vol 126 (5) ◽  
pp. 382-387 ◽  
Author(s):  
Young-Soo Chang ◽  
Ji Eun Choi ◽  
Jungmin Ahn ◽  
Nam-Gyu Ryu ◽  
Il Joon Moon ◽  
...  
Keyword(s):  
Hearing Loss ◽  
High Risk ◽  
Sensorineural Hearing Loss ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Risk Group ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Risk Scores ◽  
Framingham Risk

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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