scholarly journals A comparative study of cardiovascular disease risk among bus drivers and bus conductors of a state transport corporation in North Goa

Author(s):  
Shefalee Pai Vernekar ◽  
Hemangini Kishore Shah

Background: Bus drivers and bus conductors are predisposed to increased cardiovascular disease (CVD) risks.Driving for long duration involves prolonged sitting, which enforces sedentary behavior among drivers in comparison to conductors who have the freedom to move aboutBackground: Bus drivers and bus conductors are predisposed to increased cardiovascular disease (CVD) risks.Driving for long duration involves prolonged sitting, which enforces sedentary behavior among drivers in comparison to conductors who have the freedom to move about in the bus. The aim and objectives of the study were to identify selected risk factors for CVDs among bus drivers and bus conductors; to estimate the CVDs risk among them using Framingham risk score and to study the difference of risk factors and CVDs risk between bus drivers and conductors.Methods: The present study was a comparative cross-sectional study among 105 bus drivers and 105 bus conductors at the Panaji bus depot of Goa. A pre-designed semi-structured questionnaire was used to collect data along with anthropometric, clinical examination and blood investigations. The Framingham risk score with BMI and lipids was used to compare the CVD risk.Results: Higher percentage of bus drivers had diabetes, hypertension, obesity and dyslipidemia. When the CVD risk was compared using the Framingham risk score, 63.8% bus drivers had intermediate-high CVD risk using FRS-BMI compared to 46.7% bus conductors and the difference is found to be significant. Using FRS- lipids, 65.7% bus drivers had intermediate-high risk compared to 53.3% bus conductors.Conclusions: The behavioral risk factors for CVD were higher among bus drivers compared to bus conductors. in the bus. Aims and objectives: 1) To identify selected risk factors for CVDs among bus drivers and bus conductors 2) To estimate the CVDs risk among them using Framingham risk score 3)To study the difference of risk factors and CVDs risk between bus drivers and conductors.Methods: The present study is a comparative cross sectional study among 105 bus drivers and 105 bus conductors at the Panaji bus depot of Goa.  A predesigned semi structured questionnaire was used to collect data along with anthropometric, clinical examination and blood investigations. The Framingham risk score with BMI and Lipids was used to compare the CVD riskResults:Higher percentage of bus drivers had diabetes, hypertension, obesity and dyslipidemia. When the CVD risk was compared using the Framingham risk score, 63.8 % bus drivers had intermediate-high CVD risk using FRS-BMI compared to 46.7 % bus conductors and the difference is found to be significant. Using FRS-Lipids, 65.7 % bus drivers had intermediate-high risk compared to 53.3 % bus conductors.Conclusion: The behavioural risk factors for CVD were higher among bus drivers compared to bus conductors.

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Engelin E. Emor ◽  
Agnes L. Panda ◽  
Janry Pangemanan

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


Author(s):  
Martiningsih Martiningsih ◽  
Abdul Haris

Penyakit kardiovaskular (PKV) adalah penyakit yang disebabkan oleh gangguan fungsi jantung dan pembuluh darah. PKV dapat dicegah terutama pada kelompok berisiko, diantaranya dengan penilaian risiko menggunakan Framingham Risk Score (FRS). Tujuan penelitian ini adalah untuk menganalisis risiko PKV dan korelasinya dengan Ankle Brachial Index (ABI) dan obesitas pada peserta Prolanis di Kota Bima. Pengambilan data menggunakan instrumen Framingham Risk Score, pengukuran tekanan darah, indeks massa tubuh, lingkar lengan, dan lingkar perut. Jenis penelitian ini adalah penelitian deskriptif analitik dengan rancangan cross-sectional. Pemilihan sampel ditentukan secara consecutive sampling pada semua responden yang aktif mengikuti kegiatan Prolanis dan memenuhi kriteria inklusi di lima Puskesmas di Kota Bima tahun 2018. Analisis data dengan uji parametrik Spearman. Hasil penelitian menunjukkan kelompok risiko tinggi 33 orang (40,7%), risiko sedang 28 orang (34,6%), dan risiko rendah 20 orang (24,7%). Tidak terdapat korelasi antara risiko PKV dengan ABI dan obesitas. Temuan lain dalam penelitian ini mengindikasikan adanya korelasi antara risiko PKV dengan subvariabel obesitas sentral walaupun tidak ditemukan adanya signifikansi (p> 0,05). Pada penelitian selanjutnya, disarankan jumlah sampel yang lebih banyak di komunitas dengan proporsi laki-laki dan perempuan yang berimbang. Kata Kunci: ABI, Framingham, kardiovaskuler, obesitas Abstract Risk of Cardiovascular Disease at Chronic Disease Management Program Participants in The Community Health Centers of Bima Town: The Correlation with Ankle Brachial Index and Obesity. Cardiovascular disease (CVD) is a disease caused by impaired heart and blood vessel function, which can be prevented, especially in risk groups that can be risk assessed using the Framingham Risk Score (FRS). The purpose of this study was to analyze the risk of CVD and the correlation with ABI and obesity in Prolanis participants at Bima City. Data collection was done by using the instrument FRS and measuring systolic blood pressure, body mass index, arm circumference, and waist circumference. This study was a descriptive-analytic study with a cross-sectional design. The sample selection was determined by consecutive sampling for all respondents who actively participated in Prolanis activities and fulfilled the inclusion criteria in five community health center at Bima City in 2018. Data analyzed with Spearmen parametric test. The results of research showed high risk group was 33 peoples (40.7%), moderate risk was 28 peoples (34.6%), and low risk was 20 peoples (24.7%). There was no correlation between risk of CVD  with ABI and obesity. Other findings in this study indicate a correlation between CVD risk and subvariable central obesity, although no significance was found (p> 0.05). In further research, it is recommended that a larger number of samples in the general community with a balanced proportion of men and women. Keywords:  ABI, cardiovaskuler, Framingham, obesity


2021 ◽  
Vol 4 (1) ◽  
pp. 71-83
Author(s):  
GA Amusa ◽  
G Osaigbovo ◽  
L Imoh ◽  
B Awokola

HIV/AIDS is an increasingly important cause of cardiovascular (CVD) morbidity world-wide. We sought to evaluate the prevalence of CVD risk factors in HIV positive (HIV+) adults and assessment of these risks using the Framingham risk score (FRS). A cross-sectional study of adult clients of the HIV clinic at Jos University Teaching Hospital. One hundred and fifty HIV+ selected randomly with 50 (age and sex matched) HIV negative (HIV-) participants were enrolled. Relevant history, physical examination and biochemical investigations and 12-lead electrocardiography were performed. Data was analyzed using Epi-info 7.2 statistical software and P value < 0.05 was considered significant. The prevalent major CVD risk factors were dyslipidaemia (30.0% versus 6.0%), hypertension (34.0% versus 10.0%) and diabetes mellitus (10.0% versus 2.0%) among the HIV+ and HIV- participants respectively. The FRS of the HIV+, 3 (IQR 3-28) were statistically significantly higher than that of the HIV- participants, 2 (IQR 1-13); P=0.001. Furthermore, 32% of the HIV+ had moderate-high FRS compared to 2% of HIV- participants. CD4 count ≤ 200 cells/ml, use of anti-retroviral (ART), ART use ≥ 2 years and use of protease inhibitors (PI) emerged as predictors of moderate-high FRS among the HIV+ participants. In conclusion, a high prevalence of CVD risk factors exists among HIV+ population in our local environment. These risk factors can be identified early by baseline/periodic cardiovascular work-up which should include use of CVD risk tools. Early diagnosis and treatment will significantly reduce morbidity and mortality in these patients.


2019 ◽  
Vol 22 (3) ◽  
pp. 200-208
Author(s):  
Martiningsih Martiningsih ◽  
Abdul Haris

Penyakit kardiovaskular (PKV) adalah penyakit yang disebabkan oleh gangguan fungsi jantung dan pembuluh darah. PKV dapat dicegah terutama pada kelompok berisiko, diantaranya dengan penilaian risiko menggunakan Framingham Risk Score (FRS). Tujuan penelitian ini adalah untuk menganalisis risiko PKV dan korelasinya dengan Ankle Brachial Index (ABI) dan obesitas pada peserta Prolanis di Kota Bima. Pengambilan data menggunakan instrumen Framingham Risk Score, pengukuran tekanan darah, indeks massa tubuh, lingkar lengan, dan lingkar perut. Jenis penelitian ini adalah penelitian deskriptif analitik dengan rancangan cross-sectional. Pemilihan sampel ditentukan secara consecutive sampling pada semua responden yang aktif mengikuti kegiatan Prolanis dan memenuhi kriteria inklusi di lima Puskesmas di Kota Bima tahun 2018. Analisis data dengan uji parametrik Spearman. Hasil penelitian menunjukkan kelompok risiko tinggi 33 orang (40,7%), risiko sedang 28 orang (34,6%), dan risiko rendah 20 orang (24,7%). Tidak terdapat korelasi antara risiko PKV dengan ABI dan obesitas. Temuan lain dalam penelitian ini mengindikasikan adanya korelasi antara risiko PKV dengan subvariabel obesitas sentral walaupun tidak ditemukan adanya signifikansi (p> 0,05). Pada penelitian selanjutnya, disarankan jumlah sampel yang lebih banyak di komunitas dengan proporsi laki-laki dan perempuan yang berimbang. Kata Kunci: ABI, Framingham, kardiovaskuler, obesitas Abstract Risk of Cardiovascular Disease at Chronic Disease Management Program Participants in The Community Health Centers of Bima Town: The Correlation with Ankle Brachial Index and Obesity. Cardiovascular disease (CVD) is a disease caused by impaired heart and blood vessel function, which can be prevented, especially in risk groups that can be risk assessed using the Framingham Risk Score (FRS). The purpose of this study was to analyze the risk of CVD and the correlation with ABI and obesity in Prolanis participants at Bima City. Data collection was done by using the instrument FRS and measuring systolic blood pressure, body mass index, arm circumference, and waist circumference. This study was a descriptive-analytic study with a cross-sectional design. The sample selection was determined by consecutive sampling for all respondents who actively participated in Prolanis activities and fulfilled the inclusion criteria in five community health center at Bima City in 2018. Data analyzed with Spearmen parametric test. The results of research showed high risk group was 33 peoples (40.7%), moderate risk was 28 peoples (34.6%), and low risk was 20 peoples (24.7%). There was no correlation between risk of CVD  with ABI and obesity. Other findings in this study indicate a correlation between CVD risk and subvariable central obesity, although no significance was found (p> 0.05). In further research, it is recommended that a larger number of samples in the general community with a balanced proportion of men and women. Keywords:  ABI, cardiovaskuler, Framingham, obesity


2021 ◽  
Vol 7 ◽  
pp. 237796082198913
Author(s):  
Linlin Lindayani ◽  
Heni purnama ◽  
Nunung Nurhayati ◽  
Diwa Agus Sudrajat ◽  
Taryudi Taryudi

Introduction Cardiovascular disease (CVD) is the primary cause of death in HIV patients. The number of HIV patients suffering from cardiovascular disease is almost twice as high as that of patients who are not HIV-positive. Objective The purpose of this study was to evaluate risk of cardiovascular disease among HIV-positive persons. Methods We conducted a cross-sectional study with HIV positive individuals at public health center and non-AIDS govermental organization. We enrolled people diagnosed with HIV, age over 30 years old, and on CVD medications. We collected data of demographic, anthropometric and clinical information, smoking history, and non-fasting cholesterol and blood glucose. Estimation of 10-years CVD risk was calculated using the BMI-based Framingham Risk Score. Results Of 150 participants enrolled, 66.7% were male and mean age was 38.09 (SD = 7.99) years. The mean current CD4 counts was 493.3 (SD = 139.8) cells/mm3. Female were younger, had a shorter duration living with HIV and a shorted duration of receiving ART than males. About 8.7% of respondents had a high risk of developing a CVD event in the next 10 years, and higher among females than males. The most common CVD risk factors were smoking, high blood pressure, and hypercholestrolemia. Conclusion Our study demonstrates that HIV positive persons who are at risk for developing CVD in the next 10-years. There is an increasing need for educational programs on CVD prevention for the HIV-positive person and to further facilitate the identification of persons at elevated risk in routine practice.


2017 ◽  
Vol 28 (2) ◽  
pp. 235-251 ◽  
Author(s):  
Zyad T. Saleh ◽  
Alison Connell ◽  
Terry A. Lennie ◽  
Alison L. Bailey ◽  
Rami A. Elshatarat ◽  
...  

We hypothesized that risk factors for cardiovascular disease (CVD) would be associated with worse health perceptions in prison inmates. This study included 362 inmates recruited from four medium security prisons in Kentucky. Framingham Risk Score was used to estimate the risk of developing CVD within the next 10 years. A single item on self-rated health from the Medical Outcomes Survey–Short Form 36 was used to measure health perception. Multinomial logistic regression showed that for every 1-unit increase in Framingham Risk Score, inmates were 23% more likely to have rated their health as fair/poor and 11% more likely to rate their health as good rather than very good/excellent. These findings demonstrate that worse health perceptions may serve as a starting point for discussing cardiovascular risk factors and prevention with inmates.


Author(s):  
Marzieh Saei Ghare Naz ◽  
Ali Sheidaei ◽  
Ali Aflatounian ◽  
Fereidoun Azizi ◽  
Fahimeh Ramezani Tehrani

Background Limited and conflicting evidence is available regarding the predictive value of adding adverse pregnancy outcomes (APOs) to established cardiovascular disease (CVD) risk factors. Hence, the objective of this study was to determine whether adding APOs to the Framingham risk score improves the prediction of CVD events in women. Methods and Results Out of 5413 women who participated in the Tehran Lipid and Glucose Study, 4013 women met the eligibility criteria included for the present study. The exposure and the outcome variables were collected based on the standard protocol. Cox proportional hazard model was used to evaluate the association of APOs and CVDs. The variant of C‐statistic for survivals and reclassification of subjects into Framingham risk score categories after adding APOs was reported. Out of the 4013 eligible subjects, a total of 1484 (36.98%) women reported 1 APO, while 395 (9.84%) of the cases reported multiple APOs. Univariate proportional hazard Cox models showed the significant relations between CVD events and APOs. The enhanced model had a higher C‐statistic indicating more acceptable discrimination as well as a slight improvement in discrimination (C‐statistic differences: 0.0053). Moreover, we observed a greater risk of experiencing a CVD event in women with a history of multiple APOs compared with cases with only 1 APO (1 APO: hazard ratio [HR] = 1.22; 2 APOs: HR; 1.94; ≥3 APOs: HR = 2.48). Conclusions Beyond the established risk factors, re‐estimated CVDs risk by adding APOs to the Framingham risk score may improve the accurate risk estimation of CVD. Further observational studies are needed to confirm our findings.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 604.2-605
Author(s):  
R. Ben-Shachar ◽  
D. Flake ◽  
R. Bamford ◽  
B. Mabey ◽  
E. Sasso ◽  
...  

Background:Patients with rheumatoid arthritis (RA) are at increased risk for cardiovascular disease (CVD)[1]. Quantifying the effect of inflammation on CVD risk is important because rheumatologists can reduce inflammation with effective RA medications. A new score has been developed for predicting the risk for a CVD event (MI, stroke or CV death) in RA patients. It combines serological measures of inflammation (the multi-biomarker disease activity [MBDA] score, a measure of RA disease activity; and three individual biomarkers [TNF-RI, MMP-3 and leptin]), with age and four conventional CVD risk factors (smoking, hypertension, diabetes and history of a high- risk CVD condition)[2]. To gain insight into the potential effect that treating inflammation may have on the CVD risk score, it would be useful to know how the score is affected by the level of inflammation.Objectives:Explore the quantitative contribution of inflammation to CVD risk score in individual RA patients.Methods:To quantify the effect of inflammation on the CVD risk score across a range of MBDA scores, a commercial dataset of 177,486 RA patients with ≥2 MBDA tests between October 2010 and June 2019 was split 2:1 into training and validation datasets. Curves showing variation in the CVD risk score across the spectrum of all possible MBDA scores (1-100) were generated for canonical patient types differing in the number of conventional risk factors (0 to 4) and age (45, 55, 65, 75, 85 years). To generate these curves, the contributions of TNF-RI, MMP-3 and leptin to the CVD risk score were treated in aggregate (denoted the molecular score) and estimated using a linear regression model of the difference in molecular scores vs. the difference in MBDA scores. This model for the molecular score was fit in the training dataset, then in the full dataset, with dataset (training or validation) and the interaction between dataset and change in MBDA score included as additional predictor variables. The method was considered validated if the F-test for the interaction variable was not significant at the 0.05 level.Results:The model for estimating the molecular score from the MBDA scores was validated and shown to fit the data well (Figure 1). The estimated molecular score was applied to the CVD risk score algorithm to generate curves that show how CVD risk score varies with MBDA score for several distinct patient types. These curves demonstrate that the predicted 3-year CVD risk increases continuously and markedly with increasing level of inflammation, as represented by the MBDA score (Figure 2). Age and the number of conventional risk factors also affected the predicted CVD risk, with older patients (Figure 2a) and those with more conventional risk factors (Figure 2b) being at higher risk for a CVD event.Conclusion:The level of CVD risk predicted by a new prognostic test for RA patients depends not only on conventional risk factors, which are relatively time invariant, but also varies greatly due to inflammation, which can potentially be reduced with RA treatment.References:[1]Agca et al (2017).Ann Rheum Dis.76(1):17-28. doi: 10.1136/annrheumdis-2016-209775.[2]Curtis JR, Xie F, Crowson CS et al. (2019) ACR meeting abstract #446Disclosure of Interests:Rotem Ben-Shachar Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Darl Flake Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Richard Bamford Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Brent Mabey Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Eric Sasso Shareholder of: Myriad Genetics, Inc., Employee of: Myriad Genetics, Inc., Jeffrey Curtis Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Corrona, Janssen, Lilly, Myriad, Pfizer, Regeneron, Roche, UCB


2021 ◽  
Vol 9 ◽  
Author(s):  
Nayla Cristina do Vale Moreira ◽  
Ibrahimu Mdala ◽  
Akhtar Hussain ◽  
Bishwajit Bhowmik ◽  
Tasnima Siddiquee ◽  
...  

Background and Aims: Cardiovascular diseases (CVDs) are the leading cause of death globally and in Brazil. Evidence suggests that the risk of CVDs differs by race/ethnicity. Scarce information exists about the association between CVD risk, obesity indicators and sociodemographic characteristics in the Brazilian population.Objectives: We aimed to assess the CVD risk following the Framingham risk score in relation to the population's sociodemographic profile. Further, we examined the association between anthropometric markers and risk of CVDs.Methods: A total of 701 subjects aged ≥20 years from North-eastern Brazil were recruited randomly to participate in a population-based, cross-sectional survey. Age-adjusted data for CVD risk, sociodemographic characteristics, and anthropometric indices were assessed, and their relationships examined.Results: High CVD risk (Framingham risk score ≥10%) was observed in 18.9% of the population. Males (31.9 vs. 12.5%) and older subjects (age ≥45 years: 68.9% vs. age &lt;45 years: 4.2%) had significantly higher risk of CVDs, whereas those employed in manual labor showed lower risk (7.6 vs. 21.7%). Central obesity measures like waist-to-hip ratio and waist-to-height ratio were more strongly associated with predicted CVD risk than body mass index.Conclusions: Our population had a high risk of CVDs using the Framingham risk score. Cost-effective strategies for screening, prevention and treatment of CVDs may likely reduce disease burden and health expenditure in Brazil. Central obesity measures were strongly associated with predicted CVD risk and might be useful in the clinical assessment of patients. Follow-up studies are warranted to validate our findings.


2017 ◽  
Vol 63 (1) ◽  
pp. 278-287 ◽  
Author(s):  
Ali Abbasi ◽  
Lyanne M Kieneker ◽  
Eva Corpeleijn ◽  
Ron T Gansevoort ◽  
Rijk O B Gans ◽  
...  

Abstract BACKGROUND Somatostatin is a component of the well-known insulin-like growth factor-1/growth hormone (GH) longevity axis. There is observational evidence that increased GH is associated with an increased risk of cardiovascular disease (CVD). We aimed to investigate the potential association of plasma N-terminal fragment prosomatostatin (NT-proSST) with incident CVD and all-cause mortality in apparently healthy adults. METHODS We studied 8134 participants without history of CVD (aged 28–75 years; women, 52.6%) from the Prevention of Renal and Vascular End-stage Disease (PREVEND) study in Groningen, the Netherlands. Plasma NT-proSST was measured in baseline samples. Outcomes were incidence of CVD and all-cause mortality. RESULTS In cross-sectional analyses, NT-proSST [mean (SD), 384.0 (169.3) pmol/L] was positively associated with male sex and age (both P &lt; 0.001). During a median follow-up of 10.5 (Q1-Q3: 9.9–10.8) years, 708 (8.7%) participants developed CVD and 517 (6.4%) participants died. In univariable analyses, NT-proSST was associated with an increased risk of incident CVD and all-cause mortality (both P &lt; 0.001). In multivariable analyses, these associations were independent of the Framingham risk factors, with hazard ratios (95% CI) per doubling of NT-proSST of 1.17 (1.03–1.34; P = 0.02) for incident CVD and of 1.28 (1.09–1.49; P = 0.002) for all-cause mortality. Addition of NT-proSST to the updated Framingham Risk Score improved reclassification (integrated discrimination improvement (P &lt; 0.001); net reclassification improvement was 2.5% (P = 0.04)). CONCLUSIONS Plasma NT-proSST is positively associated with increased risk of future CVD and all-cause mortality, partly independent of traditional CVD risk factors. Further research is needed to address the nature of associations.


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