scholarly journals Multiple Myeloma Patients Undergoing Carfilzomib: Development and Validation of a Risk Score for Cardiovascular Adverse Events Prediction

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1631
Author(s):  
Anna Astarita ◽  
Giulia Mingrone ◽  
Lorenzo Airale ◽  
Fabrizio Vallelonga ◽  
Michele Covella ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Assessment ◽  
Multiple Myeloma ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Adverse Events ◽  
Risk Score ◽  
Risk Group ◽  
High Risk Group ◽  
Cardiovascular Risk Assessment

Cardiovascular adverse events (CVAEs) are linked to Carfilzomib (CFZ) therapy in multiple myeloma (MM); however, no validated protocols on cardiovascular risk assessment are available. In this prospective study, the effectiveness of the European Myeloma Network protocol (EMN) in cardiovascular risk assessment was investigated, identifying major predictors of CVAEs. From January 2015 to March 2020, 116 MM patients who had indication for CFZ therapy underwent a baseline evaluation (including blood pressure measurements, echocardiography and arterial stiffness estimation) and were prospectively followed. The median age was 64.53 ± 8.42 years old, 56% male. Five baseline independent predictors of CVAEs were identified: office systolic blood pressure, 24-h blood pressure variability, left ventricular hypertrophy, pulse wave velocity value and global longitudinal strain. The resulting ‘CVAEs risk score’ distinguished a low- and a high-risk group, obtaining a negative predicting value for the high-risk group of 90%. 52 patients (44.9%) experienced one or more CVAEs: 17 (14.7%) had major and 45 (38.7%) had hypertension-related events. In conclusion, CVAEs are frequent and a specific management protocol is crucial. The EMN protocol and the risk score proved to be useful to estimate the baseline risk for CVAEs during CFZ therapy, allowing the identification of higher-risk patients.

scholarly journals Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Average Risk ◽  
Cvd Risk ◽  
Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

scholarly journals The CUORE project cardiovascular risk assessment in primary care: the ongoing experience in Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Palmieri ◽  
S Vannucchi ◽  
C Lo Noce ◽  
A Di Lonardo ◽  
B Unim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Adult Population ◽  
Cardiovascular Risk Assessment ◽  
Project Risk ◽  
Preventive Actions

Abstract Background Italian National Prevention Plan 2005-08 included 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE Project risk score. GPs were encouraged to perform 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim To show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population. Methods Data were collected using the cuore.exe software, freely downloadable by GPs from the CUORE Project website (www.cuore.iss.it). The CRO provides a web-platform to compare data on 10-CR and risk factors at regional/national level. For persons examined at least twice, variations in risk factors from baseline to follow-up and 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results Up to February 2019, about 3,500 GPs downloaded cuore.exe; about 300,000 CR assessments on about 140,000 persons were sent to CRO. Mean CR was 3.1% in women (W), 8.5% in men (M); 28% of M, 64% of W were at low risk (CR < 3%); 9.9% of M, 0.4% of W were at high risk (CR ≥ 20%); 26% of M, 16% of W were current smokers; 13% of M, 10% of W were diabetic; 33% of hypertensive M, 35% of hypertensive W were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14% of M, 7% of W). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (0.2-0.7 mmHg), total cholesterol by 4.1 mg/dl (3.0-5.2 mg/dl), smokers prevalence by 3.1% (2.3%-4.0%); HDL-cholesterol increased in W by 0.3 mg/dl (0.1-0.5 mg/dl). Conclusions Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. Individual risk score is a useful tool for GPs to assess CR and promote primary prevention focusing on the adoption of healthy lifestyles. Data can be used to support health policy decision process. Key messages The cuore.exe software, freely downloadable from the CUORE Project website-www.cuore.iss.it, allows GPs to assess the CUORE Project risk score, to collect and to send data to the CVD Risk Observatory. 10 year Cardiovascular Risk assessment in the general adult population can be an effective first step to implement preventive actions in primary care.

Abstract P394: The Ongoing Experience of Cardiovascular Risk Assessment Implementation in Primary Care of The Cuore Project

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Luigi Palmieri ◽  
Rita Rielli ◽  
Chiara Donfrancesco ◽  
Patrizia De Sanctis Caiola ◽  
Francesco Dima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Lower Risk ◽  
Matched Pair ◽  
Cardiovascular Risk Assessment ◽  
Preventive Actions

Background: The Italian National Prevention Plan 2005–2008 included a 10-year cardiovascular risk assessment (10-CR) for the general population aged 35–69 years using the CUORE-Project risk score. GPs were encouraged to collect data on risk factors, perform a 10-CR and send these data to the Cardiovascular Risk Observatory (CRO). Aim: The aim of this study is to show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population, a first step to implement primary preventive actions at individual level. Methods: A training plan for GPs was launched by the Ministry of Health. Data were collected using the cuore.exe software, easily and freely downloadable by GPs from the CUORE-Project website ( www.cuore.iss.it ). The CRO provides a web-platform to analyze and compare data on 10-CR and risk factors at both regional and national level. In the subgroup of persons examined at least twice a year, variations in continuous risk factors mean levels and categorical risk factors prevalences between baseline and follow-up and their 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results: By October 2011, more than 3,000 GPs downloaded cuore.exe ; 146,322 CR assessments on 137,773 persons were sent to CRO. CR mean was 3.0% in women, 8.4% in men; 30% of men and 65% of women were at lower risk (CR<3%), 9.3% of men and 0.4% of women were at high risk (CR≥20%). Thirty-four percent of men and 19% of women were current smokers, 13% of men and 10% of women were diabetic, and 33% of hypertensive men and 35% of hypertensive women were under specific treatment. Among those with at least two risk assessments (n=8,495), 7% (95%–C.I. 6%–8%) shifted to a lower risk class after one year (9% of men and 5% of women respectively). Systolic blood pressure mean levels decreased by 1.3 mmHg (95%–C.I. 0.9–1.8 mmHg), diastolic blood pressure by 0.9 mmHg (95%–C.I. 0.5–1.3 mmHg), total cholesterol level by 5.7 mg/dl (95%–C.I. 4.4–6.9 mg/dl),6.6 mg/dl6 and smokers prevalence by 3.6% (95%–C.I. 2.6%–4.7%)6.6 mg/dl6; HDL-cholesterol increased in women by 0.8 mg/dl (95%–C.I. 0.4–1.2 mg/dl). Conclusions: Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. The individual risk score is becoming a useful tool for GPs to assess their patients’ CR and promote primary prevention by focusing attention on the adoption of healthy lifestyles. These encouraging data can be used to support health policy decision processes.

Abstract P118: The Ongoing Experience of Cardiovascular Risk Assessment Implementation in Primary Care of the CUORE Project

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Luigi Palmieri ◽  
Serena Vannucchi ◽  
Cinzia Lo Noce ◽  
Anna Di Lonardo ◽  
Daniela Minutoli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
Risk Score ◽  
Lower Risk ◽  
Matched Pair ◽  
Cardiovascular Risk Assessment ◽  
Preventive Actions

Background: The Italian National Prevention Plan 2005-2008 included a 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE-Project risk score. GPs were encouraged to collect data on risk factors, perform a 10-CR and send data to the Cardiovascular Risk Observatory (CRO). Aim: The aim of this study is to show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population, a first step to implement primary preventive actions at individual level. Methods: A training plan for GPs was launched by the Ministry of Health. Data were collected using the cuore.exe software, easily and freely downloadable by GPs from the CUORE-Project website (www.cuore.iss.it). The CRO provides a web-platform to analyze and compare data on 10-CR and risk factors at both regional and national level. In the subgroup of persons examined at least twice a year, variations in continuous risk factors mean levels and categorical risk factors prevalence between baseline and follow-up and their 95% confidence intervals (C.I.) were calculated using methods for matched pair samples. Results: By October 2019, about 3,500 GPs downloaded cuore.exe ; about 300,000 CR assessments on about 140,000 persons were sent to CRO. CR mean was 3.1% in women, 8.5% in men; 28% of men and 64% of women were at lower risk (CR<3%), 9.9% of men and 0.4% of women were at high risk (CR≥20%). Twenty-six percent of men and 16% of women were current smokers, 13% of men and 10% of women were diabetic, and 33% of hypertensive men and 35% of hypertensive women were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14 of men and 7% of women respectively). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (95%-C.I. 0.2-0.7 mmHg), total cholesterol level by 3.1% (95%-C.I. 2.3%-4.0%)6.6 mg/dl6; HDL-cholesterol increased in women by 0.3 mg/dl (95%-C.I. 0.1-0.5 mg/dl). Conclusions: Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. The individual risk score is becoming a useful tool for GPs to assess their patients’ CR and promote primary prevention by focusing attention on the adoption of healthy lifestyles. These encouraging data can be used to support health policy decision processes.

scholarly journals Cardiovascular Risk Assessment: A Comparison of the Framingham, PROCAM, and DAD Equations in HIV-Infected Persons

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Max Weyler Nery ◽  
Celina Maria Turchi Martelli ◽  
Erika Aparecida Silveira ◽  
Clarissa Alencar de Sousa ◽  
Marianne de Oliveira Falco ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
High Risk ◽  
Risk Group ◽  
Cross Sectional Study ◽  
High Risk Group ◽  
Cardiovascular Risk Assessment ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Group Data ◽  
Low Hdl

This study aims to estimate the risk of cardiovascular disease (CVD) and to assess the agreement between the Framingham, Framingham with aggravating factors, PROCAM, and DAD equations in HIV-infected patients. A cross-sectional study was conducted in an outpatient centre in Brazil. 294 patients older than 19 years were enrolled. Estimates of 10-year cardiovascular risk were calculated. The agreement between the CVD risk equations was assessed using Cohen's kappa coefficient. The participants' mean age was 36.8 years (SD = 10.3), 76.9% were men, and 66.3% were on antiretroviral therapy. 47.8% of the participants had abdominal obesity, 23.1% were current smokers, 20.0% had hypertension, and 2.0% had diabetes. At least one lipid abnormality was detected in 72.8%, and a low HDL-C level was the most common. The majority were classified as having low risk for CV events. The percentage of patients at high risk ranged from 0.4 to 5.7. The PROCAM score placed the lowest proportion of the patients into a high-risk group, and the Framingham equation with aggravating factors placed the highest proportion of patients into the high-risk group. Data concerning the comparability of different tools are informative for estimating the risk of CVD, but accuracy of the outcome predictions should also be considered.

scholarly journals Cardiovascular risk assessment in multiple myeloma patients undergoing carfilzomib therapy: a new risk prediction model for cardiovascular adverse events

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Astarita ◽  
G Mingrone ◽  
L Airale ◽  
F Vallelonga ◽  
C Catarinella ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Multiple Myeloma ◽  
Risk Score ◽  
Blood Pressure Variability ◽  
Longitudinal Strain ◽  
Pulse Wave ◽  
Global Longitudinal Strain ◽  
Cardiovascular Risk Assessment

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular adverse events (CVAEs) are closely related to Carfilzomib (CFZ) therapy in multiple myeloma (MM), but validated management protocols are lacking. Moreover, the incidence, nature and risk factors for each type of CVAEs are incompletely characterized. Purpose To assess if the European Myeloma Network Guidelines (EMN) protocol is effective on cardiovascular risk assessment before CFZ starting. A prediction model for estimating the probability of CVAEs was developed and validated. Major and hypertensive-related CVAEs were investigated. Methods A perspective study on 116 MM patients scheduled for CFZ therapy was conducted from 2015 to 2020. Before CFZ starting, a baseline evaluation, according to the EMN protocol, was performed; during the follow-up, the incidence of CVAEs was detected. The potential risk factors for CVAEs were identified and a risk score was developed. Results The rate of all-grade CVAEs was 44.8% (24.1% CTCAE≥3): 14.7% experienced major CVEAs (41.2% arrhythmias, 23.5% acute ischemic cardiopathy as most represented) and 30.2% hypertensive-related CVAEs. At baseline, five independent predictors for all-CVAEs were identified: office systolic blood pressure (p = 0.003), 24-hours blood pressure variability (p = 0.004), left ventricular mass (p = 0.015), pulse wave velocity (p = 0.002) and global longitudinal strain (p = 0.033). The resulting CVAEs risk score allows to define the low- and high-risk groups, obtaining a sensibility of 94% in predicting CVAEs (AUC 0.76). Conclusions The comprehensive evaluation of EMN Guidelines is effective in CVAEs prediction. The use of CVAEs risk score will identify the higher risk patients, targeting appropriate follow-ups and organizing effective risk mitigation strategies. Instrumental determinants with CVAEs Parameters No CVAEs N = 64 [N (%)] CVAEs N = 52[N (%)] P value LV mass/BSA 85.30 ± 19.72 95.14 ± 21.75 0.013 LV hypertrophy [&gt; = 95 g/m2 F &gt; = 115 g/m2 M] 8 (12.7) 16 (30.8) 0.018 LV dilation 5 (9.3) 4 (8.9) 0.949 LV EF % 63.03 ± 6.56 61.96 ± 7.13 0.414 GLS % -22.37 ± 2.56 -21.3 ± 2.46 0.029 LV Diastolic dysfunction 1 (1.6) 0(0) 0.362 PWV 7.41 ± 1.63 8.55 ± 1.855 0.002 PWV &sup3; 8.75 m/s 10 (17.5) 24 (54.2) 0.000 SBP Systolic Blood Pressure; ABPM Ambulatory Blood Pressure Monitoring; BPV Blood Pressure Variability; BSA Body Surface Area; SD Standard Deviation; EF Ejection Fraction; GLS Global Longitudinal Strain; LV Left Ventricle; PWV Pulse Wave Velocity Abstract Figure. CVAEs risk score

Abstract WMP59: Premorbid Blood Pressure Control of Incident Transient Ischaemic Attacks and Strokes; Prevalence and Determinants; Analysis of Individual Patient Data over 10 Years

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Chamila Mettananda ◽  
Lixin Li ◽  
Gary Lau ◽  
Rose Wharton ◽  
Linda Bull ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Blood Pressure Control ◽  
Risk Group ◽  
Pressure Control ◽  
High Risk Group ◽  
High Risk Patients ◽  
Transient Ischaemic Attacks ◽  
Risk Patients

Background: Uncontrolled blood pressure is the most important modifiable risk factor for strokes. Aims and Methods: We determined the prevalence and determinants of blood pressure control in patients with incident transient ischaemic attacks(TIA) and strokes from 2002-2012 in a population-based cohort(Oxford Vascular Study). Controlled blood pressure(BP) was defined as having BP<140/90mmHg and was studied in different cardiovascular risk groups according to the Framingham 10-year general cardiovascular risk(CV-Risk) predicted at time of event and 10years pre-event; low(≤ 10%), moderate(11-19%) and high(≥ 20%) risk. We also studied the associations of controlled BP adjusted for age and sex. Results: Among 1741 patients with incident TIA/strokes, 1051 (60.4%) had known hypertension, of which 891 (84.8%) were on anti-hypertensive treatment. However, only 698 (40.1%) of all and 306 (29.1%) of treated patients had controlled BP. On predicted 10-year CV-Risk at event, 861 (72.5%) of 1188 (77.0%) in high risk group had known hypertension, of which 758 (88.0%) were on treatment. However, only 346 (29.1%) of all in high-risk group and 190 (25.1%) of treated high risk patients had controlled BP. In contrast, 120 (88.2%) of 136 (8.8%) in low risk group had controlled BP. Risk stratification without scoring for BP showed consistent results except the number in high-risk group dropped to 863 (55.9%). Analysis with CV-risk 10years pre-event also showed similar trends. Age(adjusted OR=0.97, 95%CI=0.97-0.98, p<0.001), high CV-risk at event/10years pre-event (0.97, 0.95-0.99, p<0.013, 0.95-0.99, p=0.008), being treated for hypertension(0.43, 0.35-0.52, p<0.001), BMI≥ 30Kg/m2(0.72, 0.55-0.92, p=0.010) and high total cholesterol(0.91, 0.84-0.99, p<0.026) were negatively associated with controlled BP. However history of atrial fibrillation(1.35, 1.03-1.77, p=0.030) and physical dependency(modified-Rankin-Scale>2; 1.54, 1.15-2.06, p<0.001) were positively associated with controlled BP. Conclusions: Premorbid blood pressure control in patients with incident TIA/strokes was inadequate especially in high-risk patients. Controlling BP to targets in elderly and high CV-risk patients would be important in reducing incident TIA/strokes.

Comparison of SCORE and Reynolds cardiovascular risk assessments in a cohort without cardiovascular disease

2013 ◽  
Vol 154 (43) ◽  
pp. 1709-1712 ◽  
Author(s):  
Csaba Móczár
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Screening Program ◽  
Risk Group ◽  
Scoring Systems ◽  
High Risk Group ◽  
Risk Assessments ◽  
Gender And Age ◽  
Medium Risk

Introduction: Cardiovascular risk assessment may help in the identification of symptom-free subjects with high cardiovascular risk. Aim: The author studied the correlation between SCORE and Reynolds risk assessment systems based on data from the cardiovascular risk screening program carried out in subjects without cardiovascular disease. Method: Data obtained from 4462 subjects (1977 men and 2485 women; mean age, 47,4 years) were analysed. The comparison was based on risk categories of the SCORE system. Results: There was a strong correlation between the two scoring systems in the low risk population (under <2% SCORE risk the Spearman rho = 1, p < 0.001). A weak correlation was found in the medium risk group (between 3–4% the Spearman rho = 0.59–0.49, p < 0.001 and between 10–14% the Spearman rho = 0.42, ns.) and a stronger correlation in the high risk group (>15% the Spearmen rho = 0.8, p = 0.017). When correlations were analysed in gender and age categories, the weakest correlation was detected in medium risk women over 40 years of age. In cases when the differences between the two scoring systems were significant, the hsCRP levels were significantly higher (4.1 vs. 5.67 mg/L, p < 0.001). Conclusions: Introduction of hsCRP into cardiovascular risk assessments can refine the risk status of symptom-free subjects, especially among intermediate risk middle-age women (two-step risk assessment). Orv. Hetil., 154 (43), 1709–1712.

Short-term risk stratification using CADILLAC risk score in patients with ST elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Satou ◽  
H Kitahara ◽  
K Ishikawa ◽  
T Nakayama ◽  
Y Fujimoto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Adverse Events ◽  
Risk Score ◽  
Risk Group ◽  
Risk Groups ◽  
Low Risk ◽  
Short Term ◽  
Recurrent Myocardial Infarction ◽  
St Elevation

Abstract Background The recent reperfusion therapy for ST-elevation myocardial infarction (STEMI) has made the length of hospital stay shorter without adverse events. CADILLAC risk score is reportedly one of the risk scores predicting the long-term prognosis in STEMI patients. Purpose To invenstigate the usefulness of CADILLAC risk score for predicting short-term outcomes in STEMI patients. Methods Consecutive patients admitted to our university hospital and our medical center with STEMI (excluding shock, arrest case) who underwent primary PCI between January 2012 and April 2018 (n=387) were enrolled in this study. The patients were classified into 3 groups according to the CADILLAC risk score: low risk (n=176), intermediate risk (n=87), and high risk (n=124). Data on adverse events within 30 days after hospitalization, including in-hospital death, sustained ventricular arrhythmia, recurrent myocardial infarction, heart failure requiring intravenous treatment, stroke, or clinical hemorrhage, were collected. Results In the low risk group, adverse events within 30 days were significantly less observed, compared to the intermediate and high risk groups (n=13, 7.4% vs. n=13, 14.9% vs. n=58, 46.8%, p&lt;0.001). In particular, all adverse events occurred within 3 days in the low risk group, although adverse events, such as heart failure (n=4), recurrent myocardial infarction (n=1), stroke (n=1), and gastrointestinal bleeding (n=1), were substantially observed after day 4 of hospitalization in the intermediate and high risk groups. Conclusions In STEMI patients with low CADILLAC risk score, better short-term prognosis was observed compared to the intermediate and high risk groups, and all adverse events occurred within 3 days of hospitalization, suggesting that discharge at day 4 might be safe in this study population. CADILLAC risk score may help stratify patient risk for short-term prognosis and adjust management of STEMI patients. Initial event occurrence timing Funding Acknowledgement Type of funding source: None

Ten-year Cardiovascular Disease Risk Amongst Workers in a Tertiary Healthcare Institution in Kuala Lumpur

2020 ◽  
Vol 1 (1) ◽  
pp. 35-45
Author(s):  
Norfazilah Ahmad ◽  
Santhna Letchmi Panduragan ◽  
Chong Hong Soon ◽  
Kalaiarasan Gemini ◽  
Yee San Khor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Diastolic Blood Pressure ◽  
Associated Factors ◽  
Risk Group ◽  
High Risk Group ◽  
Kuala Lumpur ◽  
Cvd Risk ◽  
Tertiary Healthcare

  Strategising, which is an effective workplace intervention to curb cardiovascular disease (CVD), requires understanding of the CVD risk related to a specific working population. The Framingham Risk Score (FRS) is widely used in predicting the ten-year CVD risk of various working populations. This study aimed to use FRS to determine the ten-year CVD risk amongst workers in a tertiary healthcare setting and its associated factors. A cross-sectional study was conducted on workers who participated in the special health check programme at the staff clinic of a tertiary healthcare institution in Kuala Lumpur, Malaysia. A set of data sheets was used to retrieve the workers’ sociodemographic and CVD risk information. The prevalence of high, moderate and low ten-year CVD risk was 12.8%, 20.0% and 67.2%, respectively. Workers in the high-risk group were older [mean age: 54.81 (standard deviation, 5.72) years], male (44%), smokers (72.7%) and having hyperglycaemia (46.7%) and hypertriglyceridemia [median triglycerides: 1.75 (interquartile range, 1.45) mmol/L]. Diastolic blood pressure (aOR 1.07, 95% CI: 1.01,1.14), hyperglycaemia (aOR 8.80, 95% CI: 1.92,40.36) and hypertriglyceridemia (aOR 4.45, 95% CI: 1.78,11.09) were significantly associated with high ten-year CVD risk. Diastolic blood pressure (aOR 1.08, 95% CI: 1.03,1.13) and hypertriglyceridemia (aOR 2.51, 95% CI: 1.12-5.61) were significantly associated with moderate ten-year CVD risk. The prevalence of high and moderate ten-year CVD risk was relatively high. Amongst the workers in the high-risk group, they were older, male, smokers and with high fasting blood sugar and triglyceride. Understanding the ten-year CVD risk and its associated factors could be used to plan periodic workplace health assessment and monitor to prevent CVD.

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