Prediction of cardiovascular risk in cancer patients of South India using WHO/ISH risk prediction charts and Framingham score – A prospective study

2017 ◽  
Vol 24 (5) ◽  
pp. 354-358 ◽  
Author(s):  
MG Rajanandh ◽  
S Suresh ◽  
K Manobala ◽  
R Nandhakumar ◽  
G Jaswanthi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cancer Patients ◽  
Risk Prediction ◽  
Smoking Status ◽  
Risk Groups ◽  
Framingham Score ◽  
Prediction Tools ◽  
Significant Difference

Objective Despite the fact that cancer and heart diseases are interconnected, there is lack of information about the prevalence of cardiovascular risk in cancer patients in the South Indian population. With this background, the present study sought to predict the cardiovascular disease in cancer patients. Methods A prospective, cross-sectional study was conducted in the Department of Medical Oncology, Sri Ramachandra University and Hospital, India. Patients’ demographic details, medical information, height, weight, body mass index, blood pressure, total cholesterol and HDL-cholesterol were measured. Two risk prediction tools, namely World Health Organization/International Society of hypertension (WHO/ISH) risk prediction charts and Framingham score were used to assess the prevalence of cardiovascular risk over 10 years. Results A total of 70 patients were included for the study. Breast and stomach cancer were found to be most among the study patients. Cardiovascular disease was assessed using WHO/ISH and Framingham risk assessment tool. With respect to WHO/ISH risk, there is a significant difference in gender, type of cancer, smoking status and age between the risk groups. Males have a high risk compared to females, and smokers have a high risk compared to non-smokers. With respect to Framingham score, there is a significant difference in gender, smoking status and systolic blood pressure between the risk groups. Males have a high risk compared to females, and smokers have a high risk compared to non-smokers. A moderate degree of agreement exists between the two risk prediction tools. Conclusion The findings of the study revealed that there is a low risk of cardiovascular disease in cancer patients.

scholarly journals Predicting 10-year cardiovascular risk using WHO/ISH risk prediction chart among urban population in Salem

2018 ◽  
Vol 5 (12) ◽  
pp. 5228
Author(s):  
K. Premanandh ◽  
R. Shankar
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Prediction ◽  
Disease Risk ◽  
Smoking Status ◽  
Cardiovascular Disease Risk ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Cvd Risk ◽  
Very High

Background: Coronary vascular disease (CVD) risk estimation tools are a simple means of identifying those at high risk in a community and hence a potentially cost-effective strategy for CVD prevention in resource-poor countries. The WHO /ISH risk prediction charts provide approximate estimates of cardiovascular disease risk in people who do not have established coronary heart disease, stroke or other atherosclerotic disease.Methods: A total of 280 subjects between 40 to 70 years of age were included in this cross sectional study. Eligible households was selected randomly (every 5th household) for the interview using systematic random sampling. Age, gender, smoking status, systolic blood pressure, presence or absence of diabetes and total serum cholesterol were used to compute the total CVD risk using WHO/ISH CVD risk prediction chart. The chart stratify an individual into low (<10%), moderate (10% to <20%), high (20% to <30%), and very high (>30%) risk groups.Results: Moderate and high CVD risk were 12.14% and 7.5% respectively. Of total study participants, 2.5% had very high risk (>40%). High risk (binge drinking) alcohol drinkers (p=0.04) and abdominal obesity (p=0.0001) were significantly associated with higher CVD risk. Higher prevalence of behavioral risk factors was also reported in our study population.Conclusions: A large proportion of the population is at moderate and high cardiovascular risk. Risk stratification and identification of individuals with a high risk for CHD who could potentially benefit from intensive primary prevention efforts are critically important in reducing the burden of CVD in India.

scholarly journals Assessment of Cardiovascular Disease Risk among Qatari Patients with Type 2 Diabetes Mellitus, Attending Primary Health Care Centers, 2014

2020 ◽  
Vol 10 (1) ◽  
pp. 1-10
Author(s):  
Anees Al-yafei ◽  
Sherif O. Osman ◽  
Nagah Selim ◽  
Noora Alkubaisi ◽  
Rajvir Singh
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Prediction ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Diabetic Patients ◽  
Total Risk ◽  
Framingham Score ◽  
Very High

Background: The accumulated knowledge on the development of cardiovascular disease in diabetic patients due to clustering and synergistic interaction of multiple risk factors leads to the establishment of cardiovascular disease 10-year risk prediction tools. The management of patients based on their total risk prediction is an effective way to reduce disease burden. The behavior of such tools varies based on population and their risk profile. Objective: To estimate the total 10-year cardiovascular disease risk using General Framingham Risk Prediction Score and World Health Organization /International Society for Hypertension (WHO/ISH) Risk Prediction Chart on Qatari diabetic patients. Methods: Cross-sectional design was used. A total of 532 Qatari diabetic patients attending primary healthcare were enrolled. Data were collected using an interview administered questionnaire, anthropometric & blood pressure measurement, and medical records. The total 10-year cardiovascular disease risk was assessed using the WHO/ISH risk prediction chart and Framingham score. Results: The former categorized (81.6%) of participants as low risk and only (3.8%) as in high and very high risk. While the later categorized (12.2%) of participants as low risk and (57.6%) as in high and very high risk. No agreement between both tools in assessment of cardiovascular disease risk (κ = - 0.019, p-value = 0.216). All risk factors used by both tools illustrated a statistically significant relation with risk categories, except ‘anti-hypertensive medications intake’ in the Framingham score. Conclusion: Encouraging assessment of patients based on total risk rather than single risk factor and further study of total risk prediction can help to establish a national tool for Qatar.

scholarly journals POS0137 CARDIOVASCULAR RISK ASSOCIATED WITH TREATMENT OF ALLOPURINOL AND BENZBROMARONE IN PATIENTS WITH GOUT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 280.2-281
Author(s):  
Y. Eun ◽  
S. Y. Kang ◽  
S. Lee ◽  
H. Kim ◽  
J. Lee ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Uric Acid ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Drug Administration ◽  
Index Date ◽  
Primary Outcome ◽  
Coronary Revascularization ◽  
Significant Difference ◽  
The Mean

Background:Previous studies have shown that cardiovascular risk is increased in patients with gout. There are many studies on the effect of uric acid lowering therapy on CV risk in gout patients, but few studies have compared allopurinol and benzbromarone.Objectives:A nationwide population-based cohort study is designed to compare cardiovascular risk according to the treatment of allopurinol and benzbromarone in Korean gout patients.Methods:We used South Korea’s database of the Health Insurance Review and Assessment service (HIRA) to identify gout patients 18 years of age or older who newly started allopurinol or benzbromarone between 2009 and 2015. The start date of allopurinol or benzbromarone is defined as the index date. We excluded patients who have been prescribed uric acid lowering agents or have been on dialysis for one year prior to the index date. During the study period, patients who used uric acid lowering agents other than allopurinol and benzbromarone or who used both drugs in combination were also excluded from the study. The primary outcome of the study was the occurrence of a composite cardiovascular endpoint, which included coronary revascularization, hospitalization due to MI, ischemic stroke, and transient ischemic attack (TIA). Cox proportional hazard regression analysis and Kaplan-Meier curves were used for the analysis.Results:257,097 allopurinol initiators and 7,868 benzbromarone initiators were included in the study. The mean age was 54.4 years, 86% were male. The mean adherence of drug administration was 68.2% for allopurinol initiators and 75.5% for benzbromarone initiators. In baseline, the benzbromarone initiator had more cardiovascular comorbidities and related drug administration than the allopurinol initiator. In allopurinol and benzbromarone initiators, the adjusted hazard ratio (aHR) of the composite CV endpoint was 1.01 (95% CI 0.83-1.21), which was not significantly different. No significant difference was found between the two groups in each of the items of the composite CV endpoint and hospitalization for heart failure. The results did not change even when 1:3 propensity score matching was performed for baseline characteristics. In subgroup analysis of high risk patients with cardiovascular disease, there was no significant difference between allopurinol and benzbromarone initiators. However, when the analysis was limited to the group taking allopurinol ≥200mg and benzbromarone ≥50mg, there was no difference in primary outcome and other outcomes, but the risk of coronary revascularization was higher in benzbromarone initiator (aHR 1.58, 95% CI 1.16-2.14).Conclusion:In our study, there was no significant difference in cardiovascular risk between allopurinol initiator and benzbromarone initiator. In the high risk group of cardiovascular disease, there was no difference in risk between the two drugs.Disclosure of Interests:None declared

Regional Cervical Plexus Blockage for Carotid Endarterectomy in Patients with Cardiovascular Risk Factors

2015 ◽  
Vol 18 (4) ◽  
pp. 140 ◽  
Author(s):  
Mehmet Taşar ◽  
Mehmet Kalender ◽  
Okay Güven Karaca ◽  
Ata Niyazi Ecevit ◽  
Salih Salihi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Endarterectomy ◽  
Regional Anesthesia ◽  
Carotid Artery Disease ◽  
Risk Groups ◽  
Cardiac Risk ◽  
Cervical Plexus ◽  
Cardiac Risk Factors ◽  
Significant Difference

Background: Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors. <br />Methods: We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy ± patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared.<br />Results: Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P &gt; .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection.<br />Conclusion: Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed. <br /><br />

scholarly journals Very similar cardiometabolic profile in the moderate and high cardiovascular risk classes: a population-based study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Chlabicz ◽  
J Jamolkowski ◽  
W Laguna ◽  
P Sowa ◽  
M Paniczko ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Population Based ◽  
Low Risk ◽  
Public Institution ◽  
Population Based Study ◽  
The Metabolic Syndrome ◽  
Cardiometabolic Profile

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Medical University of Bialystok, Poland Background Cardiovascular disease (CVD) is a major, worldwide problem and remain the dominant cause of premature mortality in the word. Simultaneously the metabolic syndrome is a growing problem. The aim of this study was to investigate the cardiometabolic profile among cardiovascular risk classes, and to estimate CV risk using various calculators. Methods The longitudinal, population-based study, was conducted in 2017-2020. A total of 931 individuals aged 20-79 were included. Anthropometric and biochemical profiles were measured according to a standardized protocols. The study population was divided into CV risk classes according to the latest recommendation. Comparisons variables between subgroups were conducted using Dwass-Steele-Critchlow-Fligner test. To estimate CV risk were used: the  Systematic Coronary Risk Estimation system, Framingham Risk Score and LIFEtime-perspective model for individualizing CardioVascular Disease prevention strategies in apparently healthy people (LIFE-CVD). Results The mean age was 49.1± 15.5 years, 43.2% were male. Percentages of low-risk, moderate-risk, high-risk and very-high CV risk were 46.1%, 22.8%, 13.5%, 17.6%, respectively. Most of the analyzed anthropometric, body composition and laboratory parameters did not differ between the moderate and high CV risk participants, whereas the low risk group differed significantly. In the moderate and high-risk groups, abdominal distribution of adipose tissue dominated with significantly elevated parameters of insulin resistance. Interestingly, estimating lifetime risk of myocardial infarction, stroke or CV death using LIFE-CVD calculator yielded similar results in moderate and high CV risk classes. Conclusion The participants belonging to moderate and high CV risk classes have a very similar unfavorable cardiometabolic profile which may result in the similar lifetime CV risk. This may imply the need for more aggressive pharmacological and non-pharmacological management of CV risk factors in the moderate CV risk population. It would be advisable to consider combining the moderate and high risk classes into one high CV risk class, or it may be worth adding one of the parameters of abdominal fat distribution to the CV risk calculators as an expression of increased insulin resistance. Abstract Figure 1.

scholarly journals The Prognostic Value of the New Combined Hemo-Eosinophil Inflammation Index (HEI Index): A Multicenter Analysis of Anal Cancer Patients Treated with Concurrent Chemo-Radiation

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 671
Author(s):  
Margherita Rimini ◽  
Pierfrancesco Franco ◽  
Berardino De Bari ◽  
Maria Giulia Zampino ◽  
Stefano Vagge ◽  
...  
Keyword(s):  
High Risk ◽  
Cancer Patients ◽  
Anal Cancer ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
External Validation ◽  
Risk Groups ◽  
Anal Squamous Cell Carcinoma ◽  
Predictors Of Response ◽  
Risk Patients

Anal squamous cell carcinoma (SCC) is a rare tumor, and bio-humoral predictors of response to chemo-radiation (CT-RT) are lacking. We developed a prognostic score system based on laboratory inflammation parameters. We investigated the correlation between baseline clinical and laboratory variables and disease-free (DFS) and overall (OS) survival in anal SCC patients treated with CT-RT in five institutions. The bio-humoral parameters of significance were included in a new scoring system, which was tested with other significant variables in a Cox’s proportional hazard model. A total of 308 patients was included. We devised a prognostic model by combining baseline hemoglobin level, SII, and eosinophil count: the Hemo-Eosinophils Inflammation (HEI) Index. We stratified patients according to the HEI index into low- and high-risk groups. Median DFS for low-risk patients was not reached, and it was found to be 79.5 months for high-risk cases (Hazard Ratio 3.22; 95% CI: 2.04–5.10; p < 0.0001). Following adjustment for clinical covariates found significant at univariate analysis, multivariate analysis confirmed the HEI index as an independent prognostic factor for DFS and OS. The HEI index was shown to be a prognostic parameter for DFS and OS in anal cancer patients treated with CT-RT. An external validation of the HEI index is mandatory for its use in clinical practice.

Abstract P159: Coronary Artery Calcium Score Improves the Net Reclassification Index of Prevalent Cardiovascular Disease In African Americans: The Jackson Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Joseph Yeboah ◽  
Che L Smith ◽  
Mario Sims ◽  
Ervin Fox ◽  
Yaorong Ge ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
High Risk ◽  
African Americans ◽  
Diagnostic Accuracy ◽  
Coronary Artery Calcium ◽  
Smoking Status ◽  
Jackson Heart Study ◽  
Net Reclassification Improvement ◽  
Heart Study

Background: Prior studies suggest that African Americans (AA) have lower prevalence of coronary artery calcium (CAC) compared to whites, yet CAC has similar ability to predict coronary heart disease (CHD) events. The role of CAC as a screening tool for CHD risk in AA is unclear. We compared the diagnostic accuracy for CHD prevalence using the CAC score and the Framingham Risk Score (FRS) in an adult population of AA. Methods: CAC was measured in 2944 participants in the Jackson Heart Study, an NHLBI funded study of AA based in Jackson, MS. Approximately 8% of this cohort had known cardiovascular disease (CVD) defined as prior MI, angina, stroke, PTCA, CABG or PVD. Logistic regression, ROC and net reclassification index (NRI) analysis were used adjusting for age, gender, SBP, total and HDL cholesterol, smoking status, DM and BMI. FRS was calculated and those with DM were classified as high risk. Results: The mean age was 60, 65% were females, 26% had DM, 50% were obese and 30% were current or former smokers. Prevalent CVD was associated with older age, higher SBP, lower HDL and total cholesterol, and higher CAC. CAC was independently associated with prevalent CVD in our multivariable model [OR (95% CI): 1.26 (1.17, 1.35), p< 0.0001]. In ROC analysis, CAC improved the diagnostic accuracy (c statistic) of the FRS from 0.617 to 0.757 (p < 0.0001) for prevalent CVD. The FRS classified 30% of the cohort as high risk, 38.5% as intermediate risk and 31.5% as low risk. FRS classfied 51% of subjects with prevalent CVD as high risk. Addition of CAC to FRS resulted in net reclassification improvement of 4% for subjects with known CVD and 28.5% in those without CVD (see figure). Conclusion: In AA, the CAC is independently associated with prevalent CVD and improves the diagnostic accuracy of FRS for prevalent CVD by 14%. Addition of CAC improves the NRI of those with prevalent CVD by 4% and the NRI of individuals without CVD by 28.5%. Determination of CAC in AA may be useful in identifying individuals at risk of CVD and reclassifying individuals with low and intermediate FRS.

Accuracy of the CARG chemotherapy toxicity risk prediction tool in older Indian patients with cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24023-e24023
Author(s):  
Shreya Gattani ◽  
Vanita Noronha ◽  
Anant Ramaswamy ◽  
Renita Castelino ◽  
Vandhita Nair ◽  
...  
Keyword(s):  
High Risk ◽  
Cancer Patients ◽  
Risk Prediction ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Chemotherapy Toxicity ◽  
Patients With Cancer ◽  
Indian Patients ◽  
Grade 3

e24023 Background: Clinical judgement alone is inadequate in accurately predicting chemotherapy toxicity in older adult cancer patients. Hurria and colleagues developed and validated, the CARG score (range, 0–17) as a convenient and reliable tool for predicting chemotherapy toxicity in older cancer patients in America, however, its applicability in Indian patients is unknown. Methods: An observational retrospective and prospective study between 2018 and 2020 was conducted in the Department of Medical Oncology at Tata Memorial Hospital, Mumbai, India. The study was approved by the institutional ethics committee (IEC-III; Project No. 900596) and registered in the Clinical Trials Registry of India (CTRI/2020/04/024675). Written informed consent was obtained in the prospective part of the study. Patients aged ≥ 60 years and planned for systemic therapy were evaluated in the geriatric oncology clinic and their CARG score was calculated. Patients were stratified into low (0-4), intermediate (5-9) and high risk (10-17) based on the CARG scores. The CARG score was provided to the treating physicians, along with the results of the geriatric assessment. Chemotherapy-related toxicities were captured from the electronic medical record and graded as per the NCI CTCAE, version 4.0. Results: We assessed 130 patients, with a median age 69 years (IQR, 60 to 84); 72% patients were males. The common malignancies included gastrointestinal (52%) and lung (30%). Approximately 78% patients received polychemotherapy and 53% received full dose chemotherapy. Based on the CARG score, 28 (22%) patients belonged to low risk, 80 (61%) to intermediate risk and 22 (17%) to the high risk category. The AU-ROC of the CARG score in predicting grade 3-5 toxicities was 0.61 (95% CI, 0.51-0.71). The sensitivity and specificity of the CARG score in predicting grade 3-5 toxicities were 60.8% and 78.6%. Grade 3-5 toxicities occurred in 6/28 patients (21%) in the low risk group, compared to 62/102 patients (61%) in the intermediate /high risk group, p = 0.0002. There was also a significant difference in the time to development of grade 3-5 toxicities, which occurred at a median of 2.5 cycles (IQR, 1-3.8) in the intermediate /high risk group and at a median of 6 cycles (IQR, 3.5-8) in the low risk group, p = 0.0011. Conclusions: In older Indian patients with cancer, the CARG score reliably stratifies patients into low risk and intermediate/high risk categories, predicting both the occurrence and the time to occurrence of grade 3-5 toxicities from chemotherapy. The CARG score may aid the oncologist in estimating the risk-benefit ratio of chemotherapy. An important limitation was that we provided the CARG score to the treating oncologists prior to the start of chemotherapy, which may have resulted in alterations in the chemotherapy regimen and dose and may have impacted the CARG risk prediction model. Clinical trial information: CTRI/2020/04/024675.

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