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работа в перми официанткой вечером без опыта работы, Good Performance for Universal CVD Risk Prediction Model - Medscape, Cardiovascular Risk Calculators Fail Some Patients With HIV - Medscape, CHIP Tied to HFpEF and ASCVD: What’s the Link? - Medscape, PREVENT: AHA's New Risk Calculator Incorporates CKM Health - Medscape, Lp(a) and LPA Gene Score 'Modest' Predictors of CVD Risk - Medscape, No Impact of Race on Cardiovascular Risk Calculations - Medscape, CVD Risk for Ex-Smokers May Linger a Decade or More - Medscape.
Medbrief Good Performance for Universal CVD Risk Prediction ModelPauline Anderson; February 12, 2024 0TOPLINE:A universal cardiovascular disease (CVD) prediction tool performs well in patients with and without atherosclerotic CVD (ASCVD), a new study showed, suggesting this model could facilitate transition from primary to secondary prevention by streamlining risk classification.METHODOLOGY:Researchers used different models to evaluate whether established CVD predictors, including age, sex, race, diabetes, systolic blood pressure, or smoking, are associated with major adverse cardiovascular events (MACEs), including myocardial infarction (MI), stroke, and heart failure (HF), among 9138 patients, mean age 63.8 years, in the Atherosclerosis Risk in Communities (ARIC) study.Of these, 609 had ASCVD (history of MI, ischemic stroke, or symptomatic peripheral artery disease) and 8529 did not.They extended their exploration to other predictors available in clinical practice, including family history of premature ASCVD, high-sensitivity C-reactive protein, lipoprotein(a), triglycerides, and apolipoprotein B, as well as predictors of HF such as body mass index and heart rate and blood-based cardiac biomarkers.An external validation analysis included 5322 participants in the Multi-Ethnic Study of Atherosclerosis (MESA).Over a median follow-up of 18.9 years, 3209 ARIC participants (35%) developed MACE for an incidence rate per 1000 person-years of 21.3 for MACE, 12.6 for MI/stroke, and 13.8 for HF.TAKEAWAY:Of all candidate predictors, 10 variables (including established predictors and cardiac biomarkers) were included in the universal prediction model, which demonstrated good calibration in both those with ASCVD (hazard ratio [HR] C-statistic, 0.692; 95% CI, 0.650-0.735) and without ASCVD (HR C-statistic, 0.748; 95% CI, 0.726-0.770).As anticipated, the risk for MACE was generally lower in those with no prior ASCVD, but the 5-year risk in the highest quintile of predicted risk in those without ASCVD was higher than that in the lowest two quintiles of the ASCVD group.The universal risk prediction model was validated in the MESA community–based cohort; over a median follow-up of 13.7 years, 12% of participants with and without prior ASCVD developed MACE for an incidence rate per 1000 person-years of 10.2 for MACE, 7.4 for MI/stroke, and 4.3 for HF.The results were generally similar when examining individual outcomes (MI/stroke and HF) and for both no ASCVD and ASCVD groups across demographic subgroups by age, sex, and race.IN PRACTICE:The findings "support the importance of established predictors for classifying long-term CVD risk in both primary and secondary prevention settings," the authors wrote, adding an advantage to this risk prediction approach could be to help providers and patients "further personalize secondary prevention."In an accompanying Pier Sergio Saba, MD, PhD, Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy, and others said the universal risk assessment approach "is conceptually promising" but noted patients with ASCVD represented only 7% of the study population, and this population was relatively young, potentially limiting the applicability of this risk model in older individuals. Before the risk model can be used in clinical settings, results need to be validated and given incorporation of cardiac biomarkers, "careful cost-benefit analyses may also be needed," the editorial writers added.SOURCE:The study was conducted by Yejin Mok, PHD, MPH, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and colleagues. It was published online on January 29, 2024, in the .LIMITATIONS:The somewhat limited number of study participants with prior ASCVD precluded researchers from quantifying the prognostic impact of ASCVD subtypes (eg, history of MI vs stroke vs peripheral artery disease). The study didn't have data on some predictors recognized in guidelines (eg, coronary artery calcium and left ventricular ejection fraction). The ARIC analysis included only Black and White participants, and although models were validated in MESA, which included Chinese and Hispanic adults, extrapolation of results to more racially/ethnically diverse populations should be done with care.DISCLOSURES:The ARIC study received funding from the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, and Department of Health and Human Services. The MESA study was supported by the NHLBI and National Center for Advancing Translational Sciences. The study authors and editorial writers had no relevant conflicts of interest.0CreditLead image: Andrey Popov/Dreamstime Medscape Medical News © 2024 WebMD, LLCSend comments and news tips to .Cite this: Good Performance for Universal CVD Risk Prediction Model - Medscape - February 12, 2024. Comments Commenting is limited to medical professionals. To comment please . Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.TOP PICKS FOR YOURecommendationsWhat to Read Next on MedscapeBusiness of MedicineRecommended ReadingFast Five Quiz: Cardiovascular Risk Management in Older AdultsDiseases & ConditionsPrimary and Secondary Prevention of Coronary Artery DiseasenewsCardiovascular Risk Linked with Severe COVID RisknewsArtificial Sweeteners Increase Cardiovascular RiskRelated Conditions & ProceduresSlideshowExpert CommentaryPoliciesMedscapeAboutFor Advertisers GET THE MEDSCAPE APP All material on this website is protected by copyright, Copyright © 1994-2025 by WebMD LLC. This website also contains material copyrighted by 3rd parties., As anticipated, the risk for MACE was generally lower in those with no prior ASCVD, but the 5-year risk in the highest quintile of predicted risk in those without ASCVD was higher than that in the , A cardiovascular risk calculator routinely used by physicians underestimates the risk for women and Black people living with HIV in high-income countries, while it overestimates risk for people .
A new study added heart failure with preserved ejection fraction (HFpEF) to the growing list of cardiovascular conditions linked to clonal hematopoiesis of indeterminate potential (CHIP), which , The new Predicting Risk of CVD Events (PREVENT) calculator is the first risk calculator that combines measures of cardiovascular, kidney, and metabolic health to estimate risk for CVD., The investigators focused on 144,350 participants who had a 10-year ASCVD risk of 5% to 20% on the QRISK3 algorithm. The area under the ROC curve increased from 0.640 (95% CI, 0.633 – 0.647) to , Risk prediction equations performed similarly in race- and sex-stratified PCEs (C-statistic [95% CI]): Black female: 0.71 (0.68-0.75); Black male: 0.68 (0.64-0.73); White female: 0.77 (0.74-0.80 , Cardiovascular disease risk dips drastically after quitting smoking, but it may take 10 to 15 years for the risk of former smokers to reach that of 'never smokers,' much longer than previously , As a frame of reference, US expenditures related to ASCVD are estimated to be $351 billion annually. If everyone in the United States over the age of 18 were tested for Lp(a) at a cost of $100 per .